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General NPI Number Information
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NPI Number | 1124197991
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Entity Type | Organization
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Legal Business Name | YOUTH & FAMILY COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 700 S SYCAMORE ST # 201
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City | PETERSBURG
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State | VA
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Zip | 23803-5802
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Country | US
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Telephone | 804-217-4806
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Fax | 804-655-6114
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Provider Business Mailing Address
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Address Line | 700 S SYCAMORE ST STE 2B
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City | PETERSBURG
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State | VA
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Zip | 23803-5803
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Country | US
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Telephone | 804-217-4806
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Fax | 804-655-6114
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Authorized Official
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Title or Position | CEO
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Name | MR. ELLIOTT D COX
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Credential | MSW
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Telephone | 804-216-7047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 843
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License Number State | VA
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