Active NPI
Susan Young
- Professional Counselor
- Prince Frederick, MD
National Provider Identifier
1154460541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC1270
- Practice address
- 110 Hospital Rd
Suite 302
Prince Frederick, MD 20678 - Phone
- (410) 535-5602
- Fax
- (410) 535-2250
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC1270 | MD | Primary |
Addresses
Primary practice location
110 Hospital Rd
Suite 302
Prince Frederick, MD 20678
Mailing address
620 S Buchanan Street
Arlington, VA 22204
Phone (703) 486-7088
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 |
|---|---|---|---|
| LC1270 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154460541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 S BUCHANAN STREET",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "22204",
"telephone_number": "703-486-7088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 HOSPITAL RD",
"address_2": "SUITE 302",
"city": "PRINCE FREDERICK",
"state": "MD",
"postal_code": "20678",
"telephone_number": "410-535-5602",
"fax_number": "410-535-2250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "SUSAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC1270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prince Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.