Provider Demographics
NPI:1124197991
Name:YOUTH & FAMILY COUNSELING SERVICE, LLC
Entity type:Organization
Organization Name:YOUTH & FAMILY COUNSELING SERVICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:804-216-7047
Mailing Address - Street 1:700 S SYCAMORE ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5803
Mailing Address - Country:US
Mailing Address - Phone:804-217-4806
Mailing Address - Fax:804-655-6114
Practice Address - Street 1:700 S SYCAMORE ST # 201
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-5802
Practice Address - Country:US
Practice Address - Phone:804-217-4806
Practice Address - Fax:804-655-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA843322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children