John Youngblood, PSYCHOLOGIST

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1424 Issued in MA

Practice address

120 Maple St
Suite 219
Springfield, MA 01103-2203

Phone

(413) 737-3730

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Carson Center for Human Services, Inc.

  • Community/Behavioral Health Agency
  • Westfield, MA
  • NPI 1457385460
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518087329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CHESTNUT HILL RD",
            "city": "LEVERETT",
            "state": "MA",
            "postal_code": "010549732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MAPLE ST",
            "address_2": "SUITE 219",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011032203",
            "telephone_number": "413-737-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "JOHN",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "1424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "0300050",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300881",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Jean Young, PA-C
• Rita-Marie Young, OTR/L
• Shanekha T. Young
• Stephen M Young, PA-C
• Teresa F Young
• Your Comfort Home Care LLC
• Youth on the Move, Inc
• Youth Social Educational Training, Inc.
• Cheng Fang Yu, MD
• Chelsea Yvon

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.