NPIMap

Organization Active NPI

Young Mind Center, Inc.

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1942509799
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4160 Issued in AZ
Legal business name
YOUNG MIND CENTER, INC.
Practice address
3202 E Mountain View Rd
Phoenix, AZ 85028-3901
Phone
(602) 237-6653
NPI assigned
Mar 18, 2011
Last updated
Feb 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Authorized official

Name
Dr. Amanda L Wood, PSYD
Title
Clinical Psychologist
Phone
(310) 657-4461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 4160 AZ Primary

Addresses

Primary practice location

3202 E Mountain View Rd
Phoenix, AZ 85028-3901

Mailing address

3202 E Mountain View Rd
Phoenix, AZ 85028-3901
Phone (602) 237-6653

National Provider Directory

National Provider Directory
Tax ID family
Young Mind Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1942509799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 E MOUNTAIN VIEW RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283901",
            "telephone_number": "602-237-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 E MOUNTAIN VIEW RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283901",
            "telephone_number": "602-237-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MIND CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "310-657-4461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.