| Youth Connect Of Va | |
|
370 Tanyard Rd Rocky Mount VA 24151 | |
| (540) 488-5636 | |
| Not Available |
| Full Name | Youth Connect Of Va |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 370 Tanyard Rd, Rocky Mount, Virginia |
| Authorized Official Name and Position | Taylor Kyle (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5404885636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Connect Of Va Po Box 1104 Rocky Mount VA 24151-8104 Ph: (540) 488-5636 | Youth Connect Of Va 370 Tanyard Rd Rocky Mount VA 24151 Ph: (540) 488-5636 |
| NPI Number | 1972093987 |
|---|---|
| Provider Enumeration Date | 05/15/2018 |
| Last Update Date | 09/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972093987 | NPI | - | NPPES |
| 601363955 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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