Active NPI
Sydney Taylor Younginer
- Clinical Psychologist
- Brookhaven, GA
National Provider Identifier
1790393957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY004856
- Practice address
- 1777 Northeast Expy NE
Brookhaven, GA 30329-2480 - Phone
- (404) 785-7878
- NPI assigned
- Jul 14, 2020
- Last updated
- Feb 11, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY004856 | GA | Primary |
Addresses
Primary practice location
1777 Northeast Expy NE
Brookhaven, GA 30329-2480
Mailing address
1777 Northeast Expy NE
Brookhaven, GA 30329-2480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250225003319 | GA | Order and Referring Only - Other (Non-Physician) | 2163942889 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY004856 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1790393957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 NORTHEAST EXPY NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303292480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 NORTHEAST EXPY NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303292480",
"telephone_number": "404-785-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGINER",
"first_name": "SYDNEY",
"middle_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-14",
"last_updated": "2025-02-11",
"certification_date": "2025-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY004856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.