Active NPI
Jennifer Dara Young, MC, LPC
- Professional Counselor
- Glendale, AZ
National Provider Identifier
1386650224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC - 2425
- Practice address
- 4901 W Bell Rd
Suite 2
Glendale, AZ 85308-3465 - Phone
- (602) 978-0945
- Fax
- (602) 843-8028
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC - 2425 | AZ | Primary |
Addresses
Primary practice location
4901 W Bell Rd
Suite 2
Glendale, AZ 85308-3465
Mailing address
4901 W Bell Rd
Suite 2
Glendale, AZ 85308-3465
Phone (602) 978-0945
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 757750 | Other | AZ | AHCCCS |
| 506812 | Other | AZ | MHS |
| MHN | Other | AZ | 308122 |
| 252952 | Other | AR | COMPSYCH |
Other names 1
- Mrs. Jennifer Dara Maulfair
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC - 2425 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386650224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4901 W BELL RD",
"address_2": "SUITE 2",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853083465",
"telephone_number": "602-978-0945",
"fax_number": "602-843-8028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 W BELL RD",
"address_2": "SUITE 2",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853083465",
"telephone_number": "602-978-0945",
"fax_number": "602-843-8028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JENNIFER",
"middle_name": "DARA",
"credential": "MC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC - 2425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "757750",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHS",
"identifier": "506812",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "308122",
"identifier": "MHN",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "252952",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MAULFAIR",
"middle_name": "DARA",
"prefix": "MRS.",
"credential": "MC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.