Individual provider Active NPI

Sophie Young, MA, LCMHCA

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1629779483
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A18441 Issued in NC
Practice address
5587 Garden Village Way Ste D
Greensboro, NC 27410-8590
Phone
(336) 272-8090
NPI assigned
Mar 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X A18441 NC Primary

Addresses

Primary practice location

5587 Garden Village Way Ste D
Greensboro, NC 27410-8590

Mailing address

621 Fairmont St Apt C
Greensboro, NC 27401-1985
Phone (336) 541-3717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416001213 NC Practitioner - Mental Health Counselor 0840715454 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Counseling & Clinical Service LLC Multi-Specialty CurrentSince Mar 19, 2023 Accepting new patients
Young Counseling and Consulting, LLC Multi-Specialty CurrentSince Apr 7, 2025 Accepting new patients

Locations

5587 Garden Village Way
Ste D
Greensboro, NC 27410
Phone (336) 272-8090

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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1629779483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 FAIRMONT ST APT C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011985",
            "telephone_number": "336-541-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5587 GARDEN VILLAGE WAY STE D",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108590",
            "telephone_number": "336-272-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SOPHIE",
        "credential": "MA, LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.