Keith Young, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC2353 Issued in ME

Practice address

175 Union St Ste C
Bangor, ME 04401-6116

Phone

(207) 951-7811

Fax

(888) 972-1920

NPI assigned

Dec 11, 2006

Last updated

Mar 23, 2020By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in ME

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1114087251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 UNION ST STE C",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016116",
            "telephone_number": "207-951-7811",
            "fax_number": "888-972-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 UNION ST STE C",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016116",
            "telephone_number": "207-951-7811",
            "fax_number": "888-972-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KEITH",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC2353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "100029",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286460099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Louise Young, PA
• Curt Tyler Young, MD
• Jaclyn Young, CRNA
• Jane Young
• Kathleen M Young, PMHNP
• Theresa Anne Young, RN
• Michael Yu, PHARMD, RPH
• Liga Yusvirazi, MD
• Michelle Zagardo, LMSW-CC
• Sadie L Zambrano, PMHNP

• Mental Health Counselor in Bangor, ME
• Providers in Bangor, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.