| National Youth Advocate Program, Inc | |
|
7 Waveland Ave Winchester KY 40391-1231 | |
| (859) 385-4669 | |
| (859) 201-1450 |
| Full Name | National Youth Advocate Program, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7 Waveland Ave, Winchester, Kentucky |
| Authorized Official Name and Position | Kiara Williams (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6148242197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| National Youth Advocate Program, Inc 1801 Watermark Dr Ste 200 Columbus OH 43215-7088 Ph: (888) 688-9964 | National Youth Advocate Program, Inc 7 Waveland Ave Winchester KY 40391-1231 Ph: (859) 385-4669 |
| NPI Number | 1508397340 |
|---|---|
| Provider Enumeration Date | 03/23/2017 |
| Last Update Date | 08/07/2020 |
| Certification Date | 08/07/2020 |
| Medicare PECOS PAC ID | 7719258292 |
|---|---|
| Medicare Enrollment ID | O20240319003635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508397340 | NPI | - | NPPES |
| 7100485520 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Secondary |
| Provider Name | Cynthia K Reed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144375759 PECOS PAC ID: 4880683507 Enrollment ID: I20040508000142 |
| Provider Name | Dora L Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376973479 PECOS PAC ID: 2062638125 Enrollment ID: I20140725000385 |
| Provider Name | Jennifer Lynn Lord |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881232510 PECOS PAC ID: 7810338738 Enrollment ID: I20240509002124 |
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