INTERCEPT YOUTH SERVICES (NPI# 1558808329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558808329 |
| Entity Type | Organization |
| Organization Name | INTERCEPT YOUTH SERVICES |
| Practice Address |
5511 Staples Mill Rd Suite 102 Richmond VA 23228-5445 |
| Practice Telephone | 8044403711 |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | MRS. AMANDA GIBSON (SENIOR CLINICAL MANAGER) |
| Authorized Official Telephone | 7577242256 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699046094 | Intercept Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 410 Adkins Rd, North Chesterfield, VA 23236-2833 | 2012-01-18 |
| 1346551652 | Intercept Youth Services | Community/Behavioral Health | 5511 Staples Mill Rd Ste 102, Richmond, VA 23228-5445 | 2010-07-01 |
| Street Address |
5511 STAPLES MILL RD SUITE 102 |
| City | RICHMOND |
| State | VA |
| Zip Code | 23228-5445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619078722 | Intercept Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 5511 Staples Mill Rd, Suite 102, Richmond, VA 23228-5445 | 2006-09-25 |
| 1134777261 | James Kaleolani Pulido Terry | Social Worker | 5511 Staples Mill Rd, Richmond, VA 23228-5445 | 2019-09-02 |
| 1528579422 | Nicole Alexandra Piggott | Social Worker | 5511 Staples Mill Rd, Richmond, VA 23228-5445 | 2017-10-18 |
| 1174067029 | Katharine Head | Social Worker | 5511 Staples Mill Rd, Suite 300, Richmond, VA 23228-5445 | 2016-12-12 |
| 1558804922 | Christy Damrath | Social Worker | 5511 Staples Mill Rd, 300, Richmond, VA 23228-5445 | 2016-12-02 |
| 1366985228 | Gideon Javna | Social Worker | 5511 Staples Mill Rd, Suite 300, Richmond, VA 23228-5445 | 2016-11-28 |
| 1043691413 | Alison Lynn Youmell | Social Worker | 5511 Staples Mill Rd, Suite 300, Richmond, VA 23228-5445 | 2015-06-11 |
| 1801287966 | Monica Renee Flanagan | Social Worker | 5511 Staples Mill Rd, Suite 102, Richmond, VA 23228-5445 | 2015-02-11 |
| 1245667062 | Zachary Mccormick Gibson | Counselor | 5511 Staples Mill Rd, Richmond, VA 23228-5445 | 2013-10-11 |
| 1871932285 | Intercept Youth Services Inc | Community/Behavioral Health | 5511 Staples Mill Rd, Suite 102, Richmond, VA 23228-5445 | 2013-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992356976 | Nimos Trans LLC | Non-emergency Medical Transport (VAN) | 5608 Tumbleweed Cr. Apt (h), Henrico, VA 23228 | 2019-09-21 |
| 1245890433 | Laura Mary Walton | Counselor | 5500 Staples Mill Road, Richmond, VA 23228 | 2019-06-19 |
| 1841859121 | Rachel S Ford | Behavior Technician | 1640 E. Parham Road, Richmond, VA 23228 | 2019-06-10 |
| 1932766631 | Nathan Ellis | Behavior Technician | 1640 East Parham Road, Richmond, VA 23228 | 2019-05-29 |
| 1922545268 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 4008 E Parham Rd., Henrico, VA 23228 | 2017-01-25 |
| 1205371663 | Simple Solutions Psychiatry | Community/Behavioral Health | 4321 Kanipe Ct, Richmond, VA 23228 | 2016-12-21 |
| 1417406224 | Dan A Kniffen Lcsw LLC | Counselor | 4100 East Parham Road, Suite B, Henrico, VA 23228 | 2016-09-22 |
| 1316334394 | Bobbi Southard | Specialist/Technologist | 8301 Hungary Spring Road, Richmond, VA 23228 | 2015-04-17 |
| 1265836050 | Crystal Mcfaddin | Nurse Practitioner | 4301 East Parham Road, Henrico, VA 23228 | 2014-10-22 |
| 1013352376 | Pooja Rao | Internal Medicine | 4100 New Hermitage Dr, Henrico, VA 23228 | 2013-04-30 |
| Find all providers in zip 23228 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030054 | Life's Purpose | Residential Treatment Facility, Emotionally Disturbed Children | 1211 Lark Ln, Richmond, TX 77469-7803 | 2020-07-07 |
| 1871099721 | Imagination LLC | Residential Treatment Facility, Emotionally Disturbed Children | 318 N Wilkinson Rd, Richmond, VA 23227-1631 | 2018-03-31 |
| 1336454552 | Wernle Youth & Family Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Wernle Rd, Richmond, IN 47374-7015 | 2010-08-12 |
| 1053641167 | Postive Outlook | Residential Treatment Facility, Emotionally Disturbed Children | 3601 Springtime Ct, Richmond, VA 23223-1692 | 2010-01-12 |
| 1568698165 | Hopes Haven Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3515 Skipping Rock Way, Richmond, VA 23234-2971 | 2009-06-09 |
| 1356593693 | Jackson-feild Homes | Residential Treatment Facility, Emotionally Disturbed Children | 205 North Blvd, Richmond, VA 23220-4006 | 2008-10-17 |
| 1952567182 | Secure Haven Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 1706 Hungary Rd, Richmond, VA 23228-2335 | 2008-08-07 |
| 1134389943 | Gabrielle's House | Residential Treatment Facility, Emotionally Disturbed Children | 725 S Providence Rd, Richmond, VA 23236-3337 | 2008-06-15 |
| 1669649364 | Strong Girls, Smart Women LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5210 Lingle Ln, Richmond, VA 23234-6618 | 2008-05-12 |
| 1225200827 | Back 2 Basics, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3808 Candlegrove Ct, Richmond, VA 23223-1440 | 2008-03-24 |
| Find all providers in RICHMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.