Individual provider Active NPI

Jared Lee Young, PSY.D.

  • Clinical Social Worker
  • Camp Hill, PA
National Provider Identifier
1437391364
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014265 Issued in PA
Practice address
51 Central Boulevard
Camp Hill, PA 17011-4212
Phone
(717) 606-3796
Fax
(717) 367-9279
NPI assigned
Mar 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW014265 PA Primary

Addresses

Primary practice location

51 Central Boulevard
Camp Hill, PA 17011-4212

Mailing address

51 Central Boulevard
Camp Hill, PA 17011-4212
Phone (717) 606-3796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040719000024 PA Practitioner - Clinical Social Worker 5597744086 Practice locations: Camp Hill, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 Grandview Ave
Camp Hill, PA 17011-1745
Phone (717) 606-3796

51 Central Blvd
Camp Hill, PA 17011-4212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW014265PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Therapy, LLC PastSince Aug 1, 2020 Accepting new patients
Psychological Health Affiliates LLC PastSince Jan 1, 2006 Accepting new patients

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1437391364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CENTRAL BOULEVARD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170114212",
            "telephone_number": "717-606-3796",
            "fax_number": "717-367-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CENTRAL BOULEVARD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170114212",
            "telephone_number": "717-606-3796",
            "fax_number": "717-367-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JARED",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.