Individual provider Active NPI

Jennifer L. Young, PH.D.

  • Clinical Psychologist
  • Cincinnati, OH
National Provider Identifier
1295820579
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6950 Issued in OH
Practice address
225 Calhoun St, Suite 200
University of Cincinnati Counseling & Psychological Ser
Cincinnati, OH 45219
Phone
(513) 556-0648
Fax
(513) 556-2302
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2392-057 WI
Clinical Psychologist 103TC0700X 6950 OH Primary

Addresses

Primary practice location

225 Calhoun St, Suite 200
University of Cincinnati Counseling & Psychological Ser
Cincinnati, OH 45219

Mailing address

225 Calhoun St, Suite 200
University of Cincinnati Counseling & Psychological Ser
Cincinnati, OH 45219
Phone (513) 556-0648

Other identifiers 1

IdentifierTypeStateIssuer
39144900MedicaidWI

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2392-057WIMDPsychologist
6950OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Counseling & Psychological Services Past Accepting new patients

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1295820579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CALHOUN ST, SUITE 200",
            "address_2": "UNIVERSITY OF CINCINNATI COUNSELING & PSYCHOLOGICAL SER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45219",
            "telephone_number": "513-556-0648",
            "fax_number": "513-556-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CALHOUN ST, SUITE 200",
            "address_2": "UNIVERSITY OF CINCINNATI COUNSELING & PSYCHOLOGICAL SER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45219",
            "telephone_number": "513-556-0648",
            "fax_number": "513-556-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2392-057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39144900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.