Healthcare Provider Details

I. General information

NPI: 1033212261
Provider Name (Legal Business Name): YOUTH QUEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W NC HIGHWAY 54 STE 220
DURHAM NC
27707-5576
US

IV. Provider business mailing address

1515 W NC HIGHWAY 54 STE 220
DURHAM NC
27707-5576
US

V. Phone/Fax

Practice location:
  • Phone: 919-942-1625
  • Fax: 919-869-1387
Mailing address:
  • Phone: 919-942-1625
  • Fax: 919-869-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. EMILY K SCHOFIELD
Title or Position: EXECUTIVE DIRECTOR
Credential: QP
Phone: 919-942-1625