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YADKIN COUNTY ADVP
NPI 1003966383
Psychologist - Intellectual and Developmental Disabilities in Boonville, NC

Active since January 11, 2007CLIA 34D1071001 · Waiver
3801B RIVER ROAD, BOONVILLE, NC 27011(336) 367-5187(336) 367-3062 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Yadkin County Advp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YADKIN COUNTY ADVP (NPI 1003966383) is a healthcare organization registered as an intellectual and developmental disabilities in Boonville, North Carolina and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through July 15, 2027 and lists Terri Mikles Vestal, Advp Director, as its authorized official.

NPPES Registry Identity

NPI1003966383
Entity TypeOrganization
Primary Taxonomy103TM1800X
Legal Business NameYADKIN COUNTY SCHOOLS
Location Address3801B RIVER ROADBoonville, NC 27011-8341
Mailing Address121 Washington StYadkinville, NC 27055-7725 · (336) 367-5187 · Fax (336) 367-3062
Phone(336) 367-5187
Fax(336) 367-3062
Organization SubpartNo
Authorized OfficialTerri Mikles VestalAdvp Director · 33633675187
Enumeration DateJanuary 11, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1003966383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Intellectual and Developmental DisabilitiesBehavioral Health & Social Service Providers
Taxonomy Code103TM1800X
License✔ Licensed in NC · MHL-099-002
3801B RIVER ROAD, Boonville, NC 27011
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Other Names 1

Doing Business AsYadkin County Advp

Other Identifiers 1

Medicaid3408907NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D1071001

Yadkin County Schools · Yadkinville, NC
Active · expires Jul 15, 2027
CLIA Number34D1071001
Laboratory TypeSchool/Student Health Service
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorKendra Carroll
Laboratory Phone(336) 551-1100
Laboratory LocationYadkin County Schools121 Washington Street, Yadkinville, NC 27055
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yadkin County Schools's NPI number?

The NPI number for Yadkin County Schools is 1003966383. It was assigned to this organization in the NPPES registry on January 11, 2007. The provider is doing business as Yadkin County Advp.

Where is Yadkin County Schools located?

Yadkin County Schools is located at 3801B River Road, Boonville, NC 27011. The listed phone number is (336) 367-5187.

What is Yadkin County Schools's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Intellectual and Developmental Disabilities, with taxonomy code 103TM1800X.

Does Yadkin County Schools hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1071001) is associated with this NPI, valid through July 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Yadkin County Schools was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.