YOUTH HAVEN SERVICES, INC. NPI 1003036708

Community/Behavioral Health in Reidsville, NC

NPI 1003036708 Organization Community/Behavioral Health

About YOUTH HAVEN SERVICES, INC.

Youth Haven Services, Inc. is a provider established in Reidsville, North Carolina specializing in community/behavioral health. The NPI number of Youth Haven Services, Inc. is 1003036708 and was assigned on April 2007. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Ms. Dawn Tucker Johnson Lcsw (President)

NPI

1003036708

Provider NameYOUTH HAVEN SERVICES, INC.
Provider Location Address229 TURNER DR REIDSVILLE, NC 27320
Provider Mailing Address229 TURNER DR REIDSVILLE, NC 27320
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-26-2007
Last Update Date10-21-2020


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

YOUTH HAVEN SERVICES, INC.
229 TURNER DR
REIDSVILLE, NC
ZIP 27320
Phone: (336) 349-2233
Fax: (336) 634-0444

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Mailing Address

YOUTH HAVEN SERVICES, INC.
229 TURNER DR
REIDSVILLE, NC
ZIP 27320
Phone: (336) 349-2233
Fax: (336) 634-0444



Authorized Official

Authorized Official NameMS. DAWN TUCKER JOHNSON LCSW
Authorized Official TitlePRESIDENT
Authorized Official Phone(336) 349-2233

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
6006037MEDICAID (05)NC

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1598982670YOUTH HAVEN SERVICES, INC.
Organization
Case Management229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1588870786MISS LAKISHA DOWANNE ELLISON LCSW
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1902103765YOUTH HAVEN SERVICES, INC.
Organization
Day Training, Developmentally Disabled Services229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1063785491MS. RACHEL ANNE VAUGHN LCSW
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1245504125MRS. JESSICA ROSE SCHLOSBERG MSW
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1225396815DR. CATHERINE T. GOFFREDA
Individual
Psychologist229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1962769356MRS. JESSICA LEA MOUNIER SPENCE LPC
Individual
Counselor229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1275936320MISS TENISHA NICOLE MCLEAN
Individual
Counselor229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1396293304MS. VALARIE C MCNAIR NCC, LPC-A
Individual
Counselor (Mental Health)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1861990301 MACKENZIE ERIN GIBBONS
Individual
Counselor (Mental Health)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1487044103MRS. TIFFANY RENEE MILLS-HOWELL LPC
Individual
Counselor (Mental Health)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1811248099MS. JANE ALLEN TILLEY LCAS, LPC
Individual
Counselor (Mental Health)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1548738339 DUSTIN LUKE GANTOS LPCA
Individual
Counselor (Professional)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1356830087MRS. SYDNEY ASHLYNNE DAWSON MA, LPCA
Individual
Counselor (Mental Health)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1962061598 JANAYE SHATOYA HARGRAVE LCSWA
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1972162956 JENAY REBECCA COLE LCSWA
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1124687975 JORDAN HARRIS RAYFIELD LCSW-A
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1013579945 BRITTNEY TALIA THOMAS MSW, LCSW-A
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1144879156MISS INESHIA RESHAWN GOODS LCSW-A
Individual
Social Worker (Clinical)229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233
1780801860YOUTH HAVEN SERVICES, INC.
Organization
Community/Behavioral Health229 TURNER DR
REIDSVILLE, NC 27320
(336) 349-2233

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.