YOUTH LIFE SERVICES (NPI# 1194331918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194331918 |
| Entity Type | Organization |
| Organization Name | YOUTH LIFE SERVICES |
| Practice Address |
826a Caroline St Fredericksburg VA 22401-5806 |
| Practice Telephone | 5408400748 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | ANTAYSIA NANCE (PRESIDENT) |
| Authorized Official Telephone | 5408400748 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
826A CAROLINE ST |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-5806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893147 | Danielle Christina Nieto | Social Worker | 4528 Plank Rd # A1, Fredericksburg, VA 22407-0141 | 2019-01-01 |
| 1982126280 | James Michael Royea | Social Worker | 1498 Boos Ln, Fredericksburg, TX 78624-9782 | 2017-07-09 |
| 1770936932 | Randa Kirchner | Social Worker | 2835 Cherry Mountain Loop, Fredericksburg, TX 78624-7791 | 2016-07-22 |
| 1558718759 | Michelle Anne Buhrandt | Social Worker | 300 Maden St, Fredericksburg, VA 22407-6354 | 2016-05-17 |
| 1306214051 | Elizabeth A. Soukup-taylor | Social Worker | 406 Chatham Square Office Park Ste 102, Fredericksburg, VA 22405-2585 | 2015-09-11 |
| 1982090056 | Kareemah Stepney | Social Worker | 7204 Alpha Ct, Fredericksburg, VA 22407-2559 | 2015-04-15 |
| 1710378286 | Barbara Somers Atkins | Social Worker | 10600 Limburg Ct, Fredericksburg, VA 22408-0269 | 2015-02-05 |
| 1770903379 | Joe T. Johnson, Lcsw LLC | Social Worker | 404 Chatham Sq Park, Square Office Park, Fredericksburg, VA 22405-2544 | 2014-04-22 |
| 1831516731 | Staci Blair Marzolino | Social Worker | 306 Westwood Office Park, Fredericksburg, VA 22401-5108 | 2014-03-28 |
| 1952731481 | Tanya Lynn Meline | Social Worker | 20 Pendleton Rd, Fredericksburg, VA 22405-3041 | 2013-11-19 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.