NPIMap

Organization Active NPI

Youth Connect of Virginia, Inc.

  • Mental Health Counselor
  • Rocky Mount, VA
National Provider Identifier
1972093987
Registry record updated Sep 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
YOUTH CONNECT OF VIRGINIA, INC.
Practice address
370 Tanyard Rd
Rocky Mount, VA 24151
Phone
(540) 488-5636
NPI assigned
May 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Taylor KyleNPI 1447809348
Title
Executive Director
Phone
(540) 488-5636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

370 Tanyard Rd
Rocky Mount, VA 24151

Mailing address

PO Box 1104
Rocky Mount, VA 24151-8104
Phone (540) 488-5636

Other identifiers 1

IdentifierTypeStateIssuer
601363955MedicaidVA

Other names 1

  • Youth Connect of VA Other name

National Provider Directory

National Provider Directory

Locations

370 Tanyard Rd
Rocky Mount, VA 24151
Phone (540) 488-5636

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567382400000",
    "number": "1972093987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1104",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241518104",
            "telephone_number": "540-488-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 TANYARD RD",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "24151",
            "telephone_number": "540-488-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH CONNECT OF VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2019-09-02",
        "status": "A",
        "authorized_official_last_name": "KYLE",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "540-488-5636"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601363955",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth Connect of VA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rocky Mount, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.