Active NPI
Breahna S Young
- Massage Therapist
- Fayetteville, NC
National Provider Identifier
1225905953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21636
- Practice address
- 308 Hay St Ste C
Fayetteville, NC 28301-5574 - Phone
- (910) 745-7495
- NPI assigned
- Oct 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 21636 | NC | Primary |
Addresses
Primary practice location
308 Hay St Ste C
Fayetteville, NC 28301-5574
Mailing address
1630 Derrydowne CT
Fayetteville, NC 28304-4856
Phone (910) 635-1202
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 |
|---|---|---|---|
| 21636 | NC | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Love Tonya Wellness LLC | Single Specialty | Current | Accepting new patients |
Locations
308 Hay St
Ste C
Fayetteville, NC 28301
Phone (910) 745-7495
Organizations & group practices 1
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": "1760745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760745600000",
"number": "1225905953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 DERRYDOWNE CT",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044856",
"telephone_number": "910-635-1202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 HAY ST STE C",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283015574",
"telephone_number": "910-745-7495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "BREAHNA",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-18",
"last_updated": "2025-10-18",
"certification_date": "2025-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NC",
"license": "21636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.