Healthcare Provider Details

I. General information

NPI: 1609448927
Provider Name (Legal Business Name): IYH I LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 AIRPORT RD
ROANOKE VA
24012-1119
US

IV. Provider business mailing address

5511 STAPLES MILL RD STE 102
HENRICO VA
23228-5445
US

V. Phone/Fax

Practice location:
  • Phone: 540-523-8099
  • Fax: 540-400-8808
Mailing address:
  • Phone: 804-807-1201
  • Fax: 804-264-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA WINFIELD
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 804-807-1201