YOUTH EVOLUTION TRACK LLC NPI 1558959171

NPI Information

NPI: 1558959171
Provider Name: YOUTH EVOLUTION TRACK LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
224 STEPHENSON AVE STE B
SAVANNAH, GA
ZIP 31405
Phone: (912) 675-3421
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YOUTH EVOLUTION TRACK LLC is a mental health counselor in Savannah, GA. YOUTH EVOLUTION TRACK LLC NPI is 1558959171. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

224 STEPHENSON AVE STE B
SAVANNAH, GA
ZIP 31405-921
Phone: (912) 675-3421

The provider's authorized official is Kimberly Davis .
The authorized official title is Credentialing Specialists and has the following contact phone number (912) 373-4385.

The enumeration date for this NPI number is 1/8/2021 and was last updated on 1/8/2021.

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
1	101YP2500X	Counselor	Professional			No
2	101YM0800X	Counselor	Mental Health			Yes

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
1	124764	OTHER	GEORGIA	DRUG AND ALCOHOL

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: 11/14/2023

NPI Synchronization or Removal

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