Provider Demographics
NPI:1982983318
Name:YES KIDS COUNT
Entity Type:Organization
Organization Name:YES KIDS COUNT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:E
Authorized Official - Last Name:TILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-335-5997
Mailing Address - Street 1:3900 CHAMBERLAYNE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4202
Mailing Address - Country:US
Mailing Address - Phone:804-264-2964
Mailing Address - Fax:804-264-2965
Practice Address - Street 1:3900 CHAMBERLAYNE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4202
Practice Address - Country:US
Practice Address - Phone:804-264-2964
Practice Address - Fax:804-264-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1202101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1202Medicaid