Active NPI
Christopher Jon Youngberg, LMFT, PHD
- Marriage & Family Therapist
- Ammon, ID
National Provider Identifier
1528151156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT2860
- Practice address
- 2250 Fieldstone Dr
Ammon, ID 83401-5880 - Phone
- (208) 552-3251
- NPI assigned
- Oct 2, 2006
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT2860 | ID | Primary |
Addresses
Primary practice location
2250 Fieldstone Dr
Ammon, ID 83401-5880
Mailing address
2250 Fieldstone Dr
Ammon, ID 83401-5880
Phone (208) 552-3251
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010145467 | Other | ID | REGENCE BLUE SHIELD OF ID |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT2860 | ID | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1528151156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2250 FIELDSTONE DR",
"city": "AMMON",
"state": "ID",
"postal_code": "834015880",
"telephone_number": "208-552-3251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 FIELDSTONE DR",
"city": "AMMON",
"state": "ID",
"postal_code": "834015880",
"telephone_number": "208-552-3251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBERG",
"first_name": "CHRISTOPHER",
"middle_name": "JON",
"credential": "LMFT, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "ID",
"license": "LMFT2860",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010145467",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ammon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.