Individual provider Active NPI

Heather Caldwell Young, PSY.D.

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1770036261
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
005294 Issued in AZ
Practice address
4207 E Pinchot Ave
Phoenix, AZ 85018-7215
Phone
(602) 777-3585
NPI assigned
Aug 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 005294 AZ Primary

Addresses

Primary practice location

4207 E Pinchot Ave
Phoenix, AZ 85018-7215

Mailing address

4207 E Pinchot Ave
Phoenix, AZ 85018-7215
Phone (602) 777-3585

Other practice location 1

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210111001520 AZ Practitioner - Clinical Psychologist 1557774668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4207 E Pinchot Ave
Phoenix, AZ 85018-7215
Phone (602) 777-3585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005294AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stillness Point Healing LLC Psychologist CurrentSince Sep 30, 2020 Accepting new patients

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1770036261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 E PINCHOT AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187215",
            "telephone_number": "602-777-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 E PINCHOT AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187215",
            "telephone_number": "602-777-3585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1179 N McDowell Blvd",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949546559",
            "country_code": "US",
            "telephone_number": "707-559-7540",
            "fax_number": "707-559-7620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "HEATHER",
        "middle_name": "CALDWELL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "005294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.