Individual provider Active NPI

James Robert Young, PH.D.

  • Clinical Psychologist
  • Fort Worth, TX
National Provider Identifier
1366105330
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
23013 Issued in TX
Practice address
6317 Greenway Rd
Fort Worth, TX 76116-4693
Phone
(817) 308-9487
NPI assigned
Oct 18, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 23013 TX Primary

Addresses

Primary practice location

6317 Greenway Rd
Fort Worth, TX 76116-4693

Mailing address

6317 Greenway Rd
Fort Worth, TX 76116-4693
Phone (817) 308-9487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118001008 TX Practitioner - Clinical Psychologist 5991194664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care LLCGroup PAC ID 7719126655, 67 clinicians

Practice addresses (Care Compare)

1201 Colonel Dr
Garland, TX 75043-1303
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
80
Improvement activities
40
Cost
66.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care LLC Clinical CurrentSince Jul 1, 2024 Accepting new patients
Che Behavioral Health Counseling Services of Texas, P.a. Clinical CurrentSince Nov 1, 2021 Accepting new patients

Locations

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

1112 Smith Dr
Alvin, TX 77511
Phone (281) 331-3001

2000 E Lamar Blvd
Ste 600
Arlington, TX 76006
Phone (214) 519-9473

2660 Brickyard Rd
Beaumont, TX 77703
Phone (406) 892-1533

1201 Colonel Dr
Garland, TX 75043
Phone (210) 602-1140

1025 W Yeagua St
Groesbeck, TX 76642
Phone (254) 729-3366

6534 Stuebner Airline Rd
Houston, TX 77091
Phone (713) 692-5137

825 W Kearney St
Mesquite, TX 75149
Phone (972) 288-7660

7820 Skyline Park Dr
Wht Settlemt, TX 76108
Phone (817) 246-4671

Organizations & group practices 2

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1366105330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6317 GREENWAY RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761164693",
            "telephone_number": "817-308-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6317 GREENWAY RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761164693",
            "telephone_number": "817-308-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "23013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.