Individual provider Active NPI

James Henry Young Jr., PH.D.

  • Counseling Psychologist
  • Charlotte, NC
National Provider Identifier
1144219650
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
996 Issued in NC
Practice address
5435 Prosperity Church Rd
Suite 2200
Charlotte, NC 28269-2331
Phone
(704) 863-9830
Fax
(704) 863-9831
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 996 NC Primary

Addresses

Primary practice location

5435 Prosperity Church Rd
Suite 2200
Charlotte, NC 28269-2331

Mailing address

PO Box 602120
Charlotte, NC 28260-2120
Phone (704) 863-9830

Other identifiers 1

IdentifierTypeStateIssuer
6000285MedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0996NCMDPsychologist
996NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network, Inc. Counseling Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1144219650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602120",
            "telephone_number": "704-863-9830",
            "fax_number": "704-863-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 PROSPERITY CHURCH RD",
            "address_2": "SUITE 2200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692331",
            "telephone_number": "704-863-9830",
            "fax_number": "704-863-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JAMES",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000285",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.