Kevin W Young, a Professional Medical Corporation

Primary specialty

PsychologistTaxonomy code 103T00000X

License

09967R Issued in LA

Legal business name

KEVIN W YOUNG, A PROFESSIONAL MEDICAL CORPORATION

Practice address

325 N Avenue F
Crowley, LA 70526-5042

Phone

(337) 783-5262

Fax

(337) 783-5264

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kevin W Young, MD

Title

President

Phone

(337) 783-5262

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932210663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N AVENUE F",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705265042",
            "telephone_number": "337-783-5262",
            "fax_number": "337-783-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N AVENUE F",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705265042",
            "telephone_number": "337-783-5262",
            "fax_number": "337-783-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN W YOUNG, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-783-5262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "LA",
            "license": "09967R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1997846",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.