Active NPI
Laura Elizabeth Young, M.A.
- Clinical Child & Adolescent Psychologist
- Canton, OH
National Provider Identifier
1962722355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 4641 Fulton Dr NW
Canton, OH 44718-2384 - Phone
- (330) 433-6075
- Fax
- (330) 433-1845
- NPI assigned
- Jun 8, 2010
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | Primary |
Addresses
Primary practice location
4641 Fulton Dr NW
Canton, OH 44718-2384
Mailing address
2135 Championship Cir SE
Massillon, OH 44646-8383
Phone (330) 737-1645
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1962722355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2135 CHAMPIONSHIP CIR SE",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446468383",
"telephone_number": "330-737-1645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4641 FULTON DR NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182384",
"telephone_number": "330-433-6075",
"fax_number": "330-433-1845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LAURA",
"middle_name": "ELIZABETH",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-08",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.