Michelle Young, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

102798 Issued in CA

Practice address

9677 Fairway Dr
Kelseyville, CA 95451-9568

Phone

(209) 312-0782

NPI assigned

Jul 22, 2016

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2023.

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1154774370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9677 FAIRWAY DR",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954519568",
            "telephone_number": "209-312-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9677 FAIRWAY DR",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954519568",
            "telephone_number": "209-312-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MICHELLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "102798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph William Spickler, M.D.
• Surin Srikureja, DO
• Victoria Thiesemann, MS, CCC-SLP
• John Tomlinson
• Rosanne Marie Wood, RDHAP

• All providers in Kelseyville, CA
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.