Active NPI
Michele Young
- Behavior Analyst
- Wall Township, NJ
National Provider Identifier
1821499831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1106918
- Practice address
- 916 5TH Ave
Wall Township, NJ 07719-3252 - Phone
- (609) 923-7701
- NPI assigned
- Sep 9, 2014
- Last updated
- Feb 7, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1106918 | SC | Primary |
Addresses
Primary practice location
916 5TH Ave
Wall Township, NJ 07719-3252
Mailing address
613 Alsace Lane
Fort Mill, SC 29708
Phone (609) 923-7701
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 |
|---|---|---|---|
| 1106918 | SC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738886400000",
"number": "1821499831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 ALSACE LANE",
"city": "FORT MILL",
"state": "SC",
"postal_code": "29708",
"telephone_number": "609-923-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 5TH AVE",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077193252",
"telephone_number": "609-923-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MICHELE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2025-02-07",
"certification_date": "2025-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "SC",
"license": "1106918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wall Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.