Jessica Young, LPC, CMHIMP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5479-125 Issued in WI

Practice address

129 Kenosha St
Walworth, WI 53184

Phone

(262) 607-2770

NPI assigned

Oct 16, 2014

Last updated

Nov 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Change, LLCGroup PAC ID 9830534551, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Change, LLC

  • Mental Health Counselor
  • Walworth, WI
  • NPI 1720511330
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1902200108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "city": "WALWORTH",
            "state": "WI",
            "postal_code": "53184",
            "telephone_number": "262-607-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 KENOSHA ST",
            "city": "WALWORTH",
            "state": "WI",
            "postal_code": "53184",
            "telephone_number": "262-607-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JESSICA",
        "credential": "LPC, CMHIMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5479-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walworth Elementary School
• Isabelle Wangerin
• Carol Anne Weikel, R.N.
• Glenn Alan Wergin, DMD
• WSSH Powerback Rehabilitation Services, LLC
• Krysta Zarnstorff
• Zolotorow Transportation LLC

• Professional Counselor in Walworth, WI
• Providers in Walworth, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.