Active NPI
Randall Young, LMHC
- Mental Health Counselor
- Carmel, IN
National Provider Identifier
1811169162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39001948A
- Practice address
- 703 Pro-Med LN
Carmel, IN 46032-5317 - Phone
- (317) 843-9922
- Fax
- (317) 581-3918
- NPI assigned
- Mar 27, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001948A | IN | Primary |
Addresses
Primary practice location
703 Pro-Med LN
Carmel, IN 46032-5317
Mailing address
703 Pro-Med LN
Carmel, IN 46032-5317
Phone (317) 843-9922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000867644 | Other | IN | ANTHEM BCBS |
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 |
|---|---|---|---|
| 39001948A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400544000000",
"number": "1811169162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 PRO-MED LN",
"city": "CARMEL",
"state": "IN",
"postal_code": "460325317",
"telephone_number": "317-843-9922",
"fax_number": "317-581-3918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 PRO-MED LN",
"city": "CARMEL",
"state": "IN",
"postal_code": "460325317",
"telephone_number": "317-843-9922",
"fax_number": "317-581-3918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "RANDALL",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-27",
"last_updated": "2014-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39001948A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000867644",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.