Individual provider Active NPI

Kathleen Young, PSY.D.

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1366545691
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4205 Issued in AZ
Practice address
3601 S 6TH Ave
Tucson, AZ 85723-4745
Phone
(520) 792-1450
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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 4205 AZ Primary

Addresses

Primary practice location

3601 S 6TH Ave
Tucson, AZ 85723-4745

Mailing address

1765 N Indigo Dr
Tucson, AZ 85745-1573
Phone (520) 261-0265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20231201000271 AZ Practitioner - Clinical Psychologist 0446241277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4250 E Kilmer St
Tucson, AZ 85711-2826
Phone (520) 261-0265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4205AZMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Rain Psychological Services LLC Clinical CurrentSince Sep 11, 2023 Accepting new patients
Affirming Alternatives Psychological Services, PC Clinical PastSince Nov 1, 2000 Accepting new patients

Locations

3849 E Broadway Blvd
Tucson, AZ 85716
Phone (520) 235-5259

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1366545691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 N INDIGO DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451573",
            "telephone_number": "520-261-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857234745",
            "telephone_number": "520-792-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.