| National Youth Advocate Program, Inc | |
|
4055 Faber Place Dr Ste 300 North Charleston SC 29405-8524 | |
| (800) 686-8958 | |
| Not Available |
| Full Name | National Youth Advocate Program, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4055 Faber Place Dr Ste 300, North Charleston, South Carolina |
| Authorized Official Name and Position | Kevin L Cluts (SYSTEMS ANALYST) |
| Authorized Official Contact | 6144878758 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| National Youth Advocate Program, Inc 1801 Watermark Dr Columbus OH 43215-7088 Ph: (888) 688-9964 | National Youth Advocate Program, Inc 4055 Faber Place Dr Ste 300 North Charleston SC 29405-8524 Ph: (800) 686-8958 |
| NPI Number | 1730586694 |
|---|---|
| Provider Enumeration Date | 11/20/2014 |
| Last Update Date | 03/26/2024 |
| Certification Date | 03/26/2024 |
| Medicare PECOS PAC ID | 7719258292 |
|---|---|
| Medicare Enrollment ID | O20240124003102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730586694 | NPI | - | NPPES |
| 224BHS | Medicaid | SC |
| Provider Name | Satura Long |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255948873 PECOS PAC ID: 5597118778 Enrollment ID: I20240124003807 |
| Provider Name | Justine Rachelle Dunnavant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760116057 PECOS PAC ID: 2365895471 Enrollment ID: I20240125000223 |
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