Individual provider Active NPI

Star Young

  • Addiction (Substance Use Disorder) Counselor
  • Stillwater, OK
National Provider Identifier
1922309483
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
604 S Walnut St
Stillwater, OK 74074-4222
Phone
(405) 921-8329
NPI assigned
Nov 15, 2010
Last updated
Nov 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

604 S Walnut St
Stillwater, OK 74074-4222

Mailing address

604 S Walnut St
Stillwater, OK 74074-4222
Phone (405) 921-8329

Other practice location 1

248 Windsor Way
Midwest City, OK 73110-3316
Phone (405) 921-8329

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

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1922309483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744222",
            "telephone_number": "405-921-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744222",
            "telephone_number": "405-921-8329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "248 Windsor Way",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731103316",
            "country_code": "US",
            "telephone_number": "405-921-8329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.