Susan Nilette Young, PSY. D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY7306 Issued in FL

Practice address

13400 Sutton Park Dr S
Suite 1504
Jacksonville, FL 32224-0236

Phone

(904) 223-6414

Fax

(904) 223-6418

NPI assigned

Sep 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Susan N Young Inc

  • Clinical Neuropsychologist
  • Jacksonville, FL
  • NPI 1770788390
  Medicare reassignment NPD Authorized official
• Getalife, LLC

  • Psychologist
  • Jacksonville, FL
  • NPI 1679654487
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1215039656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 IRONWOOD DR",
            "address_2": "UNIT 635",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825219",
            "telephone_number": "904-477-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 SUTTON PARK DR S",
            "address_2": "SUITE 1504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240236",
            "telephone_number": "904-223-6414",
            "fax_number": "904-223-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SUSAN",
        "middle_name": "NILETTE",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY7306",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7306",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Porter Young, MD
• Samuel Doak Young III, MD
• Sean Young, DDS
• Shannon Elisa Young, DPT
• Sonya Young
• Sydney Alexis Young, DC
• Tara Rachel Young, BIRTH DOULA
• Toni R Young, DO
• Toshiba Young
• Umar Dontay Young Sr.

• Clinical Neuropsychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.