Dr. Mark Condron Young

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5255 Issued in NC

Legal business name

DR. MARK CONDRON YOUNG

Practice address

111 Kilson Dr.
Suite 205
Mooresville, NC 28117

Phone

(704) 799-0105

NPI assigned

Jul 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Condron Young, PH.D.

Title

Sole Proprietor

Phone

(704) 799-0105

Specialties & licenses 1

Addresses

Other names 1

• Wellhaven Pastoral Counseling & Psychotherapy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063427870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 FLANDERS DR.",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174125",
            "telephone_number": "980-297-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 KILSON DR.",
            "address_2": "SUITE 205",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-799-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK CONDRON YOUNG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CONDRON",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "704-799-0105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "5255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellhaven Pastoral Counseling & Psychotherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.