Brandy Diane Young, M.C.D.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP1748 Issued in AR

Practice address

221 Lindley Lane
Newport, AR 72112

Phone

(870) 523-2124

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295801207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 YOUNG ST",
            "city": "TUCKERMAN",
            "state": "AR",
            "postal_code": "724739327",
            "telephone_number": "870-349-3037",
            "fax_number": "870-349-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LINDLEY LANE",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "72112",
            "telephone_number": "870-523-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BRANDY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "M.C.D.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP1748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "SP1748",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA PROVIDER NUMBER",
            "identifier": "12029538",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ralph Irwin Wray, LPC
• Vicki Lynn Wray
• Edward Wren
• Jennifer Lanelle Wynn, PHARMD
• Wynne Chiropractic Clinic, Inc (Butler Chiropractic Clinic)
• Carissa Young, PHARMD
• Carla Jean Young
• Rachel Elizabeth Zachary

• Speech-Language Pathologist in Newport, AR
• Providers in Newport, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.