Active NPI
Jillian Leigh Young, M.A., L.P.C.
- Professional Counselor
- Egg Harbor Township, NJ
National Provider Identifier
1962733709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00441700
- Practice address
- 6010 Black Horse Pike
Egg Harbor Township, NJ 08234-9752 - Phone
- (609) 272-0909
- Fax
- (609) 272-0157
- NPI assigned
- Jan 19, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00441700 | NJ | Primary |
Addresses
Primary practice location
6010 Black Horse Pike
Egg Harbor Township, NJ 08234-9752
Mailing address
651 7TH St
Somers Point, NJ 08244-1958
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YM0800X | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 20, 2024 through Jun 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00441700 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1962733709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "651 7TH ST",
"city": "SOMERS POINT",
"state": "NJ",
"postal_code": "082441958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6010 BLACK HORSE PIKE",
"city": "EGG HARBOR TOWNSHIP",
"state": "NJ",
"postal_code": "082349752",
"telephone_number": "609-272-0909",
"fax_number": "609-272-0157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JILLIAN",
"middle_name": "LEIGH",
"credential": "M.A., L.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-19",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00441700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YM0800X",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Egg Harbor Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.