Individual provider Active NPI

Crystal Young, PH.D.

  • Clinical Neuropsychologist
  • Kentwood, MI
National Provider Identifier
1841609369
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301015368 Issued in MI
Practice address
3230 Broadmoor Ave SE Ste D
Kentwood, MI 49512-8180
Phone
(616) 862-5603
Fax
(616) 974-6353
NPI assigned
Aug 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6301015368 MI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 6301015368 MI

Addresses

Primary practice location

3230 Broadmoor Ave SE Ste D
Kentwood, MI 49512-8180

Mailing address

3230 Broadmoor Ave SE Ste D
Kentwood, MI 49512-8180
Phone (616) 862-5603

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301015368MIMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Neuropsychology and Behavioral Health Clinical Neuropsychologist Current Accepting new patients

Locations

3230 Broadmoor Ave SE
Ste D
Kentwood, MI 49512
Phone (616) 821-7965

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": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1841609369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BROADMOOR AVE SE STE D",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495128180",
            "telephone_number": "616-862-5603",
            "fax_number": "616-974-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 BROADMOOR AVE SE STE D",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495128180",
            "telephone_number": "616-862-5603",
            "fax_number": "616-974-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301015368",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301015368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.