Individual provider Active NPI

Jennifer Young, LSC

  • School Counselor
  • Princeton, NJ
National Provider Identifier
1659970663
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
1106840 Issued in NJ
Practice address
3490 US Highway 1 Ste 11
Princeton, NJ 08540-5920
Phone
(609) 775-9067
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YS0200X 1106840 NJ Primary

Addresses

Primary practice location

3490 US Highway 1 Ste 11
Princeton, NJ 08540-5920

Mailing address

213 Carnegie Ctr Unit 7951
Princeton, NJ 08543-6098
Phone (609) 775-9067

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
1106840NJMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Una Vita Support Brokerage, LLC School CurrentSince Dec 6, 2020 Accepting new patients

Locations

3490 US Highway 1
Ste 11
Princeton, NJ 08540
Phone (609) 775-9067

Organizations & group practices 1

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1659970663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 CARNEGIE CTR UNIT 7951",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085436098",
            "telephone_number": "609-775-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 US HIGHWAY 1 STE 11",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405920",
            "telephone_number": "609-775-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENNIFER",
        "credential": "LSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, School",
            "state": "NJ",
            "license": "1106840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.