Jettie C Young, LPC, LCDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

78674 Issued in TX

Practice address

4101 Louise Lee Dr
Austin, TX 78725-4005

Phone

(512) 703-0770

NPI assigned

Oct 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1083189930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 LOUISE LEE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787254005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 LOUISE LEE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787254005",
            "telephone_number": "512-703-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JETTIE",
        "middle_name": "C",
        "credential": "LPC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "14586",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "78674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett Young
• James Downs Young, LPC
• Jasmin J Young, APRN
• Jeannette C. Young, M.S., CCC-SLP
• Jennifer Read Young, P.T.
• Joann Young, MED, BCBA
• Joshua Young
• Juliet Young, MSGC
• Kathleen Monet Young, AU.D.
• Kathryn M. Young, MA, LPC

• Mental Health Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.

Verify at the official NPI Registry.