ADVANCING YOUTH'S ACADEMY INC NPI 1588914824

NPI Information

NPI: 1588914824
Provider Name: ADVANCING YOUTH'S ACADEMY, INC

Former Legal Business Name: ALTERNATIVE YOUTH ACADEMY, INC

Classification: Psychologist - 103TF0200X
Entity Type: Organization

Specialization: Forensic

Address:
2662 HOLCOMB BRIDGE RD
SUITES 340, 328, 330
ALPHARETTA, GA
ZIP 30022
Phone: (770) 650-0000
Get Directions

ADVANCING YOUTH'S ACADEMY, INC is a forensic psychologist in Alpharetta, GA. The provider is a psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems. ADVANCING YOUTH'S ACADEMY, INC NPI is 1588914824. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Alternative Youth Academy, Inc.

The provider's business location address is:

2662 HOLCOMB BRIDGE RD
SUITES 340, 328, 330
ALPHARETTA, GA
ZIP 30022-819
Phone: (770) 650-0000
Fax: (770) 650-0002

The provider's authorized official is Rommys Alemania Beltran .
The authorized official title is Ceo and has the following contact phone number (770) 650-0000.

The enumeration date for this NPI number is 9/13/2012 and was last updated on 7/22/2015.

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	103T00000X	Psychologist		125325	GEORGIA	No
2	101Y00000X	Counselor		APC002972	GEORGIA	No
3	103TB0200X	Psychologist	Cognitive & Behavioral	APC002972	GEORGIA	No
4	247200000X	Technician, Other			GEORGIA	No
5	235Z00000X	Speech-Language Pathologist			GEORGIA	No
6	101YA0400X	Counselor	Addiction (Substance Use Disorder)	125325	GEORGIA	No
7	261QR0400X	Clinic/Center	Rehabilitation			No
8	103TC2200X	Psychologist	Clinical Child & Adolescent		GEORGIA	No
9	103TF0000X	Psychologist	Family		GEORGIA	No
10	103TP2701X	Psychologist	Group Psychotherapy		GEORGIA	No
11	101YS0200X	Counselor	School		GEORGIA	No
12	103TR0400X	Psychologist	Rehabilitation		GEORGIA	No
13	101YP1600X	Counselor	Pastoral		GEORGIA	No
14	103TF0200X	Psychologist	Forensic		GEORGIA	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	12471665	OTHER	GEORGIA	CAQH

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: 4/28/2024

NPI Synchronization or Removal

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