Individual provider Active NPI

Tammy Lynne Young

  • Professional Counselor
  • Clearfield, PA
National Provider Identifier
1720687759
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012741 Issued in PA
Practice address
60 Industrial Park Rd
Clearfield, PA 16830-6016
Phone
(814) 765-1149
Fax
(814) 765-9542
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

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
Professional Counselor 101YP2500X PC012741 PA Primary

Addresses

Primary practice location

60 Industrial Park Rd
Clearfield, PA 16830-6016

Mailing address

PO Box 319
Bigler, PA 16825-0319
Phone (814) 342-5678

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL credentialing@cenclear.org

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
PC012741PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cen Clear Child Services, Inc. CurrentSince Oct 25, 2020 Accepting new patients
Cen Clear Child Services PastSince Oct 25, 2020 Accepting new patients

Locations

60 Industrial Park Rd
Clearfield, PA 16830
Phone (814) 603-4529

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1720687759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 319",
            "city": "BIGLER",
            "state": "PA",
            "postal_code": "168250319",
            "telephone_number": "814-342-5678",
            "fax_number": "814-342-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 INDUSTRIAL PARK RD",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168306016",
            "telephone_number": "814-765-1149",
            "fax_number": "814-765-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TAMMY",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "credentialing@cenclear.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "60 Industrial Park Rd",
            "city": "Clearfield",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168306016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearfield, PA

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.