Individual provider Active NPI

Kim Young, PSYD

  • Clinical Psychologist
  • Fayetteville, NC
National Provider Identifier
1982939104
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5917 Issued in NC
Practice address
1830 Owen Dr Ste 10-12
Fayetteville, NC 28304-1611
Phone
(910) 797-3302
Fax
(910) 705-8184
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5917 NC Primary
Psychologist 103T00000X 4735 NC
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 024245-01 NY
Clinical Psychologist 103TC0700X 6421 NJ

Addresses

Primary practice location

1830 Owen Dr Ste 10-12
Fayetteville, NC 28304-1611

Mailing address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-8922

Other practice location 1

2817 Rock Merritt Avenue
Fort Bragg, NC 28310-1611
Phone (910) 907-8922

Other identifiers 1

IdentifierTypeStateIssuer
589561802MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 25, 2026 through May 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4735NCMDPsychologist
6421NJMDClinical Psychologist
024245-01NYMDClinical Psychologist
5917NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Young Psychological Services, PLLC Psychologist CurrentSince Oct 24, 2021 Accepting new patients

Locations

1830 Owen Dr
Ste 1012
Fayetteville, NC 28304
Phone (910) 740-4220

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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1982939104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 OWEN DR STE 10-12",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041611",
            "telephone_number": "910-797-3302",
            "fax_number": "910-705-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Rock Merritt Avenue",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283101611",
            "country_code": "US",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5917",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4735",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024245-01",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "6421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589561802",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.