| Intercept Youth Services, Inc | |
| 
					5673 Airport Rd Roanoke VA 24012-1119  | |
| (540) 523-8080 | |
| (540) 512-9775 | 
| Full Name | Intercept Youth Services, Inc | 
|---|---|
| Speciality | Psychiatry & Neurology | 
| Location | 5673 Airport Rd, Roanoke, Virginia | 
| Authorized Official Name and Position | Yolanda Winfield (REVENUE CYCLE MANAGER) | 
| Authorized Official Contact | 8048071201 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Intercept Youth Services, Inc 5511 Staples Mill Rd Ste 102 Richmond VA 23228-5445 Ph: (804) 864-1320  | Intercept Youth Services, Inc 5673 Airport Rd Roanoke VA 24012-1119 Ph: (540) 523-8080  | 
| NPI Number | 1730608217 | 
|---|---|
| Provider Enumeration Date | 09/15/2017 | 
| Last Update Date | 05/21/2025 | 
| Certification Date | 05/21/2025 | 
| Medicare PECOS PAC ID | 2466748744 | 
|---|---|
| Medicare Enrollment ID | O20160913001490 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730608217 | NPI | - | NPPES | 
| Provider Name | Joseph Waheb Iskandar | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1215252143 PECOS PAC ID: 1557505823 Enrollment ID: I20150403000655  | 
| Provider Name | James Kp Terry | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1134777261 PECOS PAC ID: 5092111435 Enrollment ID: I20210909001885  | 
| Provider Name | Brittany Floyd | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1962268755 PECOS PAC ID: 0840715983 Enrollment ID: I20250422000227  | 
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