Active NPI
Robert E Young, PSY.D.
- Clinical Psychologist
- Milwaukee, WI
National Provider Identifier
1023673563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2216-057
- Practice address
- 735 N Water St Ste 712
Milwaukee, WI 53202-4104 - Phone
- (414) 888-4287
- Fax
- (414) 888-4290
- NPI assigned
- May 9, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2216-057 | WI | Primary |
Addresses
Primary practice location
735 N Water St Ste 712
Milwaukee, WI 53202-4104
Mailing address
735 N Water St Ste 712
Milwaukee, WI 53202-4104
Phone (414) 888-4287
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2216-057 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1023673563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "735 N WATER ST STE 712",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532024104",
"telephone_number": "414-888-4287",
"fax_number": "414-888-4290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 N WATER ST STE 712",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532024104",
"telephone_number": "414-888-4287",
"fax_number": "414-888-4290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "ROBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-09",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "2216-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.