| Bacon Street Youth And Family Services | |
|
247 Mclaws Circle Williamsburg VA 23185 | |
| (757) 253-0111 | |
| (757) 253-2884 |
| Full Name | Bacon Street Youth And Family Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 247 Mclaws Circle, Williamsburg, Virginia |
| Authorized Official Name and Position | April Whalen (BILLING SPECIALIST) |
| Authorized Official Contact | 7572530111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bacon Street Youth And Family Services 247 Mclaws Circle Williamsburg VA 23185 Ph: (757) 253-0111 | Bacon Street Youth And Family Services 247 Mclaws Circle Williamsburg VA 23185 Ph: (757) 253-0111 |
| NPI Number | 1144376112 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144376112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 254-07-004 (Virginia) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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