Individual provider Active NPI

Colleen H Young, LMT, CLT

  • Massage Therapist
  • Clifton Park, NY
National Provider Identifier
1265838528
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
027147 Issued in NY
Practice address
9 Corporate Drive
Suite 3
Clifton Park, NY 12065
Phone
(518) 663-6000
Fax
(518) 665-3517
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 027147 NY Primary

Addresses

Primary practice location

9 Corporate Drive
Suite 3
Clifton Park, NY 12065

Mailing address

9 Corporate Drive
Suite 3
Clifton Park, NY 12065
Phone (518) 663-6000

Other identifiers 1

IdentifierTypeStateIssuer
027147OtherNYNYS MASSAGE THERAPY

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

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265838528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CORPORATE DRIVE",
            "address_2": "SUITE 3",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-663-6000",
            "fax_number": "518-665-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CORPORATE DRIVE",
            "address_2": "SUITE 3",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-663-6000",
            "fax_number": "518-665-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "COLLEEN",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "LMT, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "027147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS MASSAGE THERAPY",
            "identifier": "027147",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.