Soo Jeong Youn LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOO JEONG YOUN LLC

Practice address

103 Beethoven Ave
Waban, MA 02468-1731

Phone

(617) 286-4087

NPI assigned

Jun 16, 2021

Organization subpart

No

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

Authorized official

Name

Soo Jeong Youn, PHDNPI 1568990331

Title

Ceo

Phone

(617) 286-4087

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Soo Jeong Youn, PHD

  • Psychologist
  • Boston, MA
  • NPI 1568990331
  NPD Authorized official

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1497323307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BEETHOVEN AVE",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024681731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BEETHOVEN AVE",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024681731",
            "telephone_number": "617-286-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOO JEONG YOUN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "YOUN",
        "authorized_official_first_name": "SOO JEONG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-286-4087",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carols Shlossman, RD, MS, LDN
• Ariella Shvily, ED.D.
• Faye L. Snider, MSW,LICSW
• Marvin Snider, PH.D.
• Emily Weymouth Sonier, LICSW
• Howard Marvin Stern, M.D., PH.D.
• Maureen Sayres Van Niel, M.D.
• Waban Dental Specialist Group
• Waban Health Center, LLC
• Peggy Ellen Warren, MD

• Clinical Psychologist in Waban, MA
• Providers in Waban, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.