Active NPI
Kent Alan Young, PH D
- Clinical Psychologist
- Mentor, OH
National Provider Identifier
1891880522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 664
- Practice address
- 9500 Mentor Ave
Suite 320
Mentor, OH 44060 - Phone
- (440) 255-0333
- Fax
- (440) 255-0333
- NPI assigned
- Oct 4, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 664 | OH | Primary |
Addresses
Primary practice location
9500 Mentor Ave
Suite 320
Mentor, OH 44060
Mailing address
PO Box 1810
Mentor, OH 44061
Phone (440) 255-0333
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1891880522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1810",
"city": "MENTOR",
"state": "OH",
"postal_code": "44061",
"telephone_number": "440-255-0333",
"fax_number": "440-255-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 MENTOR AVE",
"address_2": "SUITE 320",
"city": "MENTOR",
"state": "OH",
"postal_code": "44060",
"telephone_number": "440-255-0333",
"fax_number": "440-255-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "KENT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.