Individual provider Active NPI

Jessica Allison Young

  • Addiction (Substance Use Disorder) Counselor
  • Fairborn, OH
National Provider Identifier
1568185528
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.181671 Issued in OH
Practice address
1825 Commerce Center Blvd
Fairborn, OH 45324-6336
Phone
(937) 376-8755
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.181671 OH Primary

Addresses

Primary practice location

1825 Commerce Center Blvd
Fairborn, OH 45324-6336

Mailing address

526 Monteray Ave
Kettering, OH 45419-2253
Phone (937) 900-4142

Other practice location 1

20 Livingston Ave # 4
Dayton, OH 45403-2938
Phone (937) 900-4142

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jesyoung@ethancrossingspringfield.com Direct

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

State licenses

LicenseStateTypeSpecialty
CDCA.181671OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
TCN Behavioral Health Services, Inc CurrentSince Dec 28, 2025 Accepting new patients
TCN Behavioral Health Services, Inc. Addiction (Substance Use Disorder) CurrentSince Dec 28, 2025 Accepting new patients

Locations

1825 Commerce Center Blvd
Fairborn, OH 45324
Phone (937) 376-8755

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/tcn/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1568185528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MONTERAY AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454192253",
            "telephone_number": "937-900-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 COMMERCE CENTER BLVD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246336",
            "telephone_number": "937-376-8755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Livingston Ave # 4",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454032938",
            "country_code": "US",
            "telephone_number": "937-900-4142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JESSICA",
        "middle_name": "ALLISON",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.181671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jesyoung@ethancrossingspringfield.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2317 E Home Rd",
            "city": "Springfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "455032520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.