Active NPI
Jennifer Young, LSC
- School Counselor
- Princeton, NJ
National Provider Identifier
1659970663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 1106840
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1106840 | NJ | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Una Vita Support Brokerage, LLC | School | Current | 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.
-
- School Counselor
- Princeton, NJ
- NPI 1720682792
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.