Active NPI
Gregory Allen Young, RBT
- Behavior Technician
- Fredericksburg, VA
National Provider Identifier
1437656535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1411 Princess Anne Street
Fredericksburg, VA 22401 - Phone
- (304) 951-0250
- NPI assigned
- Apr 6, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1411 Princess Anne Street
Fredericksburg, VA 22401
Mailing address
4678 Bonneville LN
Woodbridge, VA 22193-3131
Phone (304) 951-0250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Medicaid | VA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522972800000",
"number": "1437656535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4678 BONNEVILLE LN",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221933131",
"telephone_number": "304-951-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 PRINCESS ANNE STREET",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22401",
"telephone_number": "304-951-0250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "GREGORY",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-06",
"last_updated": "2018-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106S00000X",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.