Mitchell John Young, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

39003348A Issued in IN

Practice address

412 S Maple St Ste 103
Fortville, IN 46040-1681

Phone

(317) 360-5641

Fax

(317) 412-9130

NPI assigned

Jul 22, 2009

Last updated

Mar 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Young Clinical Services

  • Professional Counselor
  • Fortville, IN
  • NPI 1497437974
  NPD Authorized official

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1609006766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S MAPLE ST STE 103",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460401681",
            "telephone_number": "317-360-5641",
            "fax_number": "317-412-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S MAPLE ST STE 103",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460401681",
            "telephone_number": "317-360-5641",
            "fax_number": "317-412-9130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 W Green Meadows Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "IN",
            "postal_code": "461403082",
            "country_code": "US",
            "telephone_number": "317-360-5355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MITCHELL",
        "middle_name": "JOHN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.0007959",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": "39003348A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Weber, LMHC
• Kellie Sahm Wignall
• Veronica Lynn Woodrum, DC
• Workplace Services, LLC
• Young Clinical Services

• Professional Counselor in Fortville, IN
• Providers in Fortville, IN by specialty
• Professional Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.