MEDICARE: INTERCEPT YOUTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1619078722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERCEPT YOUTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	5511 STAPLES MILL RD
Second Line	:	SUITE 102
City	:	RICHMOND
State	:	VA
Zip	:	23228-5445
Country	:	US
Telephone Number	:	804-864-1320
Fax Number	:	804-864-1323

Provider Business Practice Location Address
First Line	:	5511 STAPLES MILL RD
Second Line	:	SUITE 102
City	:	RICHMOND
State	:	VA
Zip	:	23228-5445
Country	:	US
Telephone Number	:	804-864-1320
Fax Number	:	804-864-1323

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	YOLANDA WINFIELD
Credential	:
Telephone Number	:	804-807-1201

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	03/17/2025

Similar Medicare Providers

1396687562 — SHAKEYIA WINSTON MSW
Practice Location Address:

5511 STAPLES MILL RD STE 200
RICHMOND, VA
23228-5445

Practice Phone: 804-442-3116
Practice Fax:

1073865564 — MRS. ERIN ASHLEY SMITH LCSW
Practice Location Address:

5511 STAPLES MILL RD , SUITE 102
RICHMOND, VA
23228-5445

Practice Phone: 804-612-3322
Practice Fax: 804-864-1323

1063851178 — KRISTI MICHELLE EMMONS LPC
Practice Location Address:

5511 STAPLES MILL RD STE 102
RICHMOND, VA
23228-5445

Practice Phone: 804-612-3322
Practice Fax: 804-864-1323

1245667062 — ZACHARY MCCORMICK GIBSON
Practice Location Address:

5511 STAPLES MILL RD
RICHMOND, VA
23228-5445

Practice Phone: 804-523-6242
Practice Fax:

1578974283 — KRYSTLE DANDRIDGE LPC
Practice Location Address:

5511 STAPLES MILL RD STE 102
RICHMOND, VA
23228-5445

Practice Phone: 609-314-3099
Practice Fax:

1801287966 — MRS. MONICA RENEE FLANAGAN LCSW, CSOTP
Practice Location Address:

5511 STAPLES MILL RD , SUITE 102
RICHMOND, VA
23228-5445

Practice Phone: 804-523-6236
Practice Fax: 804-440-3711

Directions to “INTERCEPT YOUTH SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.