Myrna Borbon Young, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0807060 Issued in AR

Practice address

130 E Poplar St Ste C&D
Fayetteville, AR 72703

Phone

(479) 435-6047

Fax

(479) 755-3595

NPI assigned

Jun 5, 2006

Last updated

May 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stone Path Counseling, PLC

  • Mental Health Counselor
  • Fayetteville, AR
  • NPI 1023414885
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1487693891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E POPLAR ST STE C&D",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032532",
            "telephone_number": "479-435-6047",
            "fax_number": "479-755-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E POPLAR ST STE C&D",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-435-6047",
            "fax_number": "479-755-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MYRNA",
        "middle_name": "BORBON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A0507049",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P0807060",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0807060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207210719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lee Young, DNP/FNP
• Elizabeth Ann Young, APRN
• Jamie S Young, APRN
• Joe Michael Young Sr., MA
• Melissa Ann Young
• Stacey Rae Young, LCSW
• Youth Bridge
• Kelsey Yowell, PT, DPT
• Eunice Joanne Yutzy, CERTIFIED DOULA
• Kristin Ashley Zaharopoulos, APN

• Professional Counselor in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.