Active NPI
Bradley David Young, LCMHC
- Mental Health Counselor
- Rutland, VT
National Provider Identifier
1083930697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068.0056573
- Practice address
- 50 Kendall Ave
Rutland, VT 05701-3117 - Phone
- (802) 353-3421
- NPI assigned
- Apr 8, 2010
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068.0056573 | VT | Primary |
Addresses
Primary practice location
50 Kendall Ave
Rutland, VT 05701-3117
Mailing address
50 Kendall Ave
Rutland, VT 05701
Phone (802) 353-3421
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 |
|---|---|---|---|
| 068.0056573 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1083930697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 KENDALL AVE",
"city": "RUTLAND",
"state": "VT",
"postal_code": "05701",
"telephone_number": "802-353-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 KENDALL AVE",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057013117",
"telephone_number": "802-353-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "BRADLEY",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068.0056573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.