NPIMap

Organization Active NPI

Young Psychological Services, PLLC

  • Clinical Psychologist
  • Fayetteville, NC
National Provider Identifier
1912483348
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
YOUNG PSYCHOLOGICAL SERVICES, PLLC
Practice address
3800 Sunchase Dr
Fayetteville, NC 28306-8099
Phone
(910) 797-3302
NPI assigned
Jul 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Kim Yvonn Young, PSYDNPI 1982939104
Title
Owner
Phone
(910) 797-3302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

3800 Sunchase Dr
Fayetteville, NC 28306-8099

Mailing address

1830 Owen Dr Ste 10-12
Fayetteville, NC 28304-1611
Phone (910) 797-3302

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1912483348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 OWEN DR STE 10-12",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041611",
            "telephone_number": "910-797-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SUNCHASE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283068099",
            "telephone_number": "910-797-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "YVONN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-797-3302",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.