Active NPI
Tracy Janell Young, LADC
- Addiction (Substance Use Disorder) Counselor
- Danbury, CT
National Provider Identifier
1093084865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 000847
- Practice address
- 38 Old Ridgebury Rd
Danbury, CT 06810-5128 - Phone
- (203) 792-4515
- Fax
- (203) 748-2604
- NPI assigned
- Dec 22, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000847 | CT | Primary |
Addresses
Primary practice location
38 Old Ridgebury Rd
Danbury, CT 06810-5128
Mailing address
38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (203) 792-4515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004257516 | Medicaid | CT |
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 |
|---|---|---|---|
| 000847 | CT | MD | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1093084865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 OLD RIDGEBURY RD",
"city": "DANBURY",
"state": "CT",
"postal_code": "068105128",
"telephone_number": "203-792-4515",
"fax_number": "203-748-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 OLD RIDGEBURY RD",
"city": "DANBURY",
"state": "CT",
"postal_code": "068105128",
"telephone_number": "203-792-4515",
"fax_number": "203-748-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "TRACY",
"middle_name": "JANELL",
"name_prefix": "Mrs.",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-22",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "000847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004257516",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Danbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.