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SUPPORTED LIVING YOUTH FAMILY & CHILDREN SERVICES INC. NPI 1235272717


NPI Information

NPI: 1235272717
Provider Name: SUPPORTED LIVING YOUTH, FAMILY & CHILDREN SERVICES, INC.
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
717 WHITE OAKS CIRCLE
MONROE, NC
ZIP 28112
Phone: (704) 283-6002
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SUPPORTED LIVING YOUTH, FAMILY & CHILDREN SERVICES, INC. is a counselor in Monroe, NC. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. SUPPORTED LIVING YOUTH, FAMILY & CHILDREN SERVICES, INC. NPI is 1235272717. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

717 WHITE OAKS CIRCLE
MONROE, NC
ZIP 28112-014
Phone: (704) 283-6002
Fax: (704) 225-1582

The provider's authorized official is Kirk Anthony Hillian .
The authorized official title is Director and has the following contact phone number (704) 283-6002.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 9/3/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorNo
2101Y00000XCounselorMHL090141NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16603459MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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