Individual provider Active NPI

Durel G Young, AA

  • Behavior Technician
  • Lakeland, FL
National Provider Identifier
1508649138
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-278618 Issued in FL
Practice address
4222 S Florida Ave
Lakeland, FL 33813-1628
Phone
(863) 683-4726
NPI assigned
Aug 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CNA341248 FL
Behavior Technician 106S00000X RBT-23-278618 FL Primary

Addresses

Primary practice location

4222 S Florida Ave
Lakeland, FL 33813-1628

Mailing address

4222 S Florida Ave
Lakeland, FL 33813-1628
Phone (863) 456-7148

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
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
RBT-23-278618FLMDBehavior Technician
CNA341248FLMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1508649138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131628",
            "telephone_number": "863-456-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131628",
            "telephone_number": "863-683-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DUREL",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "AA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "CNA341248",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-278618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.