Kimberly E Youschak, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002691 Issued in CT

Practice address

400 Columbus Ave
New Haven, CT 06519-1233

Phone

(203) 503-3075

Fax

(203) 503-3296

NPI assigned

Apr 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornell Scott Hill Health CorporationGroup PAC ID 3072418359, 261 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1083009013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3075",
            "fax_number": "203-503-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3075",
            "fax_number": "203-503-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSCHAK",
        "first_name": "KIMBERLY",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Young, M.S., R.P.A.C.
• Renee Michelle Young, DO
• Robert Reed Young, PAC
• Sandra Lee Collins Young, PSY.D., L.C.S.W.
• Sherayna Young, LPC
• Sameh Yousef
• Youth Continuum
• Laura Yoviene Sykes, PH.D.
• Sara Ysaac-Garcia, DMD
• Andrew Daniel Yu, M.D.

• Professional Counselor in New Haven, CT
• Providers in New Haven, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.