Individual provider Active NPI

Mark E Young, PSY.D., BCPC, CCBT

  • Mental Health Counselor
  • Midlothian, TX
National Provider Identifier
1972657765
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19864 Issued in TX
Practice address
408 W Avenue F
Midlothian, TX 76065-2963
Phone
(972) 723-0044
Fax
(972) 775-2002
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 19864 TX Primary

Addresses

Primary practice location

408 W Avenue F
Midlothian, TX 76065-2963

Mailing address

334 W Hendricks St
Cedar Hill, TX 75104-1923
Phone (972) 291-7260

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

State licenses

LicenseStateTypeSpecialty
19864TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Counseling Assoicates, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1972657765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 W HENDRICKS ST",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751041923",
            "telephone_number": "972-291-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W AVENUE F",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760652963",
            "telephone_number": "972-723-0044",
            "fax_number": "972-775-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "PSY.D., BCPC, CCBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "19864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.