Active NPI
Colleen Perry(Young), M.S
- Marriage & Family Therapist
- Newport Beach, CA
National Provider Identifier
1932440302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 52676
- Practice address
- 1151 Dove St Ste 245
Newport Beach, CA 92660-2806 - Phone
- (951) 533-8944
- NPI assigned
- Mar 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 52676 | CA | Primary |
Addresses
Primary practice location
1151 Dove St Ste 245
Newport Beach, CA 92660-2806
Mailing address
1151 Dove St Ste 245
Newport Beach, CA 92660-2806
Phone (951) 533-8944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52676 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719705600000",
"number": "1932440302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 DOVE ST STE 245",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602806",
"telephone_number": "951-533-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1151 DOVE ST STE 245",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602806",
"telephone_number": "951-533-8944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY(YOUNG)",
"first_name": "COLLEEN",
"name_prefix": "Ms.",
"credential": "M.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-11",
"last_updated": "2024-06-30",
"certification_date": "2024-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "52676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.