Jillian Young

Primary specialty

CounselorTaxonomy code 101Y00000X

License

84585 Issued in TX

Practice address

17210 Campbell Rd
Dallas, TX 75252-4202

Phone

(214) 250-1700

NPI assigned

Feb 7, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Beckloff Pediatric Behavioral Center

  • Community/Behavioral Health Agency
  • Dallas, TX
  • NPI 1972971786
  NPD (past)

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1326792581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 DOUGLAS AVE APT 343",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193515",
            "telephone_number": "214-729-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17210 CAMPBELL RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752524202",
            "telephone_number": "214-250-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "84585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyoung@drbeckloff.com",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "Beckloff pediatric behavioral center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17210 Campbell Rd",
            "address_2": "200",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752524202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Michael Young II, PH.D.
• Debra Jean Young, CRNA
• Dwain Keith Young, LPC
• Heidi Lane Young, RN
• Jessica Young, LMT
• Karen Young, AGPCNP
• Karen Denise Young, LVN
• Katherine Suzanne Young, DO
• Kathleen Ann Young, LPC
• Kathryn Young, CRNA

• Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.