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General NPI Number Information
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NPI Number | 1871011726
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER YOUNKINS
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 317 OFFICE SQUARE LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3650
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Country | US
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Telephone | 757-376-0736
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Fax | 844-889-4940
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Provider Business Mailing Address
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Address Line | 8809 GRAMEL ST
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City | NORFOLK
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State | VA
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Zip | 23503-4813
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Country | US
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Telephone | 757-376-0736
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Fax | 844-889-4940
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER B. YOUNKINS
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Credential | LCSW
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Telephone | 757-376-0736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006850
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License Number State | VA
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