Individual provider Active NPI

Jefferson Davis Young Jr., LCP LCMFT LMLP

  • Psychologist
  • Hays, KS
National Provider Identifier
1649322108
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LMLP0161 Issued in KS
Practice address
208 E 7TH Street
High Plains Mental Health Center
Hays, KS 67601-4117
Phone
(785) 628-2871
Fax
(785) 628-0426
NPI assigned
Jan 17, 2007
Last updated
Apr 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LMLP0161 KS Primary
Psychologist 103T00000X LCP234 KS
Marriage & Family Therapist 106H00000X LCMFT121 KS

Addresses

Primary practice location

208 E 7TH Street
High Plains Mental Health Center
Hays, KS 67601-4117

Mailing address

745 West 48TH Street
Hays, KS 67601-9478
Phone (785) 625-7210

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
LCP234KSMDPsychologist
LMLP0161KSMDPsychologist
LCMFT121KSMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1649322108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 WEST 48TH STREET",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676019478",
            "telephone_number": "785-625-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E 7TH STREET",
            "address_2": "HIGH PLAINS MENTAL HEALTH CENTER",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676014117",
            "telephone_number": "785-628-2871",
            "fax_number": "785-628-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEFFERSON",
        "middle_name": "DAVIS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCP LCMFT LMLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "LMLP0161",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "LCP234",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "LCMFT121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hays, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.