Sally S. Young PHD, Professional Corporation

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

480000178 Issued in VT

Legal business name

SALLY S. YOUNG PHD, PROFESSIONAL CORPORATION

Practice address

86 Lake St
Office 307
Burlington, VT 05401-5297

Phone

(802) 862-2773

Fax

(802) 862-6496

NPI assigned

Oct 20, 2006

Last updated

Mar 7, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sally Serrell Young, PHDNPI 1467666313

Title

Licensed Psychologist - Doctorate

Phone

(802) 862-2773

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sally Serrell Young, PHD

  • Clinical Psychologist
  • Burlington, VT
  • NPI 1467666313
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1619050143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054020626",
            "telephone_number": "802-862-2773",
            "fax_number": "802-862-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 LAKE ST",
            "address_2": "OFFICE 307",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015297",
            "telephone_number": "802-862-2773",
            "fax_number": "802-862-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY S. YOUNG PHD, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "SERRELL",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST - DOCTORATE",
        "authorized_official_telephone_number": "802-862-2773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "480000178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0008363",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VT6583",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mirabelle B Sajisevi, M.D.
• Olubunmi Nkem Salako, M.D.
• Valerie Salcido, LPA, HSP-PA
• Massoud Saleki
• Richard A Salerno, M.D.
• Deborah Saltus, NP
• Beth Melanie Saltzman, MD
• Samantha Saluti
• Sam Piotrowski, M.a., PLC
• Emily Samara, MA

• Clinical Psychologist in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.