Mallori Young, MS TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6362009306 Issued in MI

Practice address

315 N Center St
Northville, MI 48167-1277

Phone

(313) 656-4052

NPI assigned

May 24, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Imagine Center LLC

  • Clinical Psychologist
  • Northville, MI
  • NPI 1467899666
  NPD (past)

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1689249583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 LAPRAIRIE ST APT 120",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202475",
            "telephone_number": "734-756-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N CENTER ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671277",
            "telephone_number": "313-656-4052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4160 Woodward Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012027",
            "country_code": "US",
            "telephone_number": "313-656-4052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MALLORI",
        "credential": "MS TLLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Wright
• Jun Xiao
• Kimberlee Xiromeritis
• Merfit Karim Yaldo, P.A-C
• Leonidas Andres Jose Ceniza Yaun
• Your Heart Matters Counseling and Consulting, LLC
• Libby Yu, NP
• Karen H. Yurko, PH.D.
• Lawrence Zager, D.O.
• Federico Zannini, PA

• Clinical Psychologist in Northville, MI
• Providers in Northville, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.