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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