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Organization
YOUTH CONNECT OF VIRGINIA, INC.
Active
Organization
YOUTH CONNECT OF VIRGINIA, INC.
Active
Other names
Youth Connect of VA
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR KYLE (EXECUTIVE DIRECTOR)
(540) 488-5636
Entity
Organization
Contact information
Practice address
370 TANYARD RD, ROCKY MOUNT, VA 24151
(540) 488-5636
Mailing address
PO BOX 1104, ROCKY MOUNT, VA 24151-8104
(540) 488-5636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601363955
—
VA
Enumeration date
05/15/2018
Last updated
09/02/2019
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