Provider Demographics
NPI:1871011726
Name:CHRISTOPHER YOUNKINS
Entity Type:Organization
Organization Name:CHRISTOPHER YOUNKINS
Other - Org Name:CHRISTOPHER B. YOUNKINS, LCSW, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:YOUNKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-376-0736
Mailing Address - Street 1:8809 GRAMEL ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-4813
Mailing Address - Country:US
Mailing Address - Phone:757-376-0736
Mailing Address - Fax:844-889-4940
Practice Address - Street 1:317 OFFICE SQUARE LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3650
Practice Address - Country:US
Practice Address - Phone:757-376-0736
Practice Address - Fax:844-889-4940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-30
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040068501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945255Medicaid