DR. KENNETH RAY YOUNG JR. (NPI# 1083927917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083927917 |
Entity Type | Individual |
Full Name | DR. KENNETH RAY YOUNG JR. |
Credential | PSYD, LP |
Practice Address |
12301 Whitewater Dr Ste 101 Minnetonka MN 55343-4157 |
Practice Telephone | 9529996097 |
Practice Fax Number | 9524260508 |
Mailing Telephone | 9529996097 |
Mailing Fax Number | 9524260508 |
Enumeration Date | 2010-07-20 |
Last Update Date | 2017-12-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP5036 | MN | Behavioral Health & Social Service Providers |
N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
LP5036 | MN | Behavioral Health & Social Service Providers |
N | 103TF0200X |
Psychologist Specialization: Forensic |
LP5036 | MN | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 1083927917 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699381095 | Kenneth Young | Marriage & Family Therapist | 37 Sturgis Rd, Edison, NJ 08817-4039 | 2020-09-21 |
1386179802 | Kenneth Young | Counselor | 169 Mansfield Ave, Shelby, OH 44875-1832 | 2017-04-21 |
1265673578 | Kenneth Young | Massage Therapist | 607 S Alexander St, Plant City, FL 33563-5053 | 2009-03-16 |
1437150067 | Kenneth A Young | Family Medicine | 8523 Madison Ave, Suite A, Indianapolis, IN 46227-6115 | 2005-08-04 |
1689041287 | Kenneth Young | Physical Therapist | 3838 50th St, Lubbock, TX 79413-3808 | 2015-08-31 |
1376957258 | Kenneth Young Jr. | Emergency Medicine | 5841 S. Maryland Ave. Mc 5068, University of Chicago Section of Emergency Medicine, Chicago, IL 60637-9997 | 2014-06-18 |
1972742112 | Kenneth George Young | Social Worker | 1818 Market St, Philadelphia, PA 19103-3638 | 2009-02-11 |
1932346442 | Kenneth Young | Rehabilitation Practitioner | 9650 Zelzah Ave, Northridge, CA 91325-2003 | 2009-01-21 |
1770732190 | Kenneth Scott Young | Physical Therapist | 244 E 84th St, 3rd Floor, New York, NY 10028-2904 | 2008-09-10 |
1578779575 | Kenneth Marvin Young | Dentist | 1 Rockefeller Plz, 2229, New York, NY 10020-2003 | 2007-05-15 |
Street Address |
12301 WHITEWATER DR STE 101 |
City | MINNETONKA |
State | MN |
Zip Code | 55343-4157 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033193172 | Laura Ann Jaap | Psychologist | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2005-12-02 |
1770102733 | Janna Marie Schriber | Counselor | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2020-04-10 |
1821644774 | David Brandsrud | Nurse Practitioner | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2019-08-15 |
1255840187 | Michaela Marie Bucchianeri | Psychologist | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2017-09-22 |
1780128306 | Melanie Natasha Gabrielle Hultgren | Marriage & Family Therapist | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2016-12-16 |
1851775308 | Ross Fulton Barr | Psychologist | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2015-07-15 |
1588094809 | Katherine Whitmire Murphy | Counselor | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2013-11-22 |
1750575379 | Amber Holmes Isham | Marriage & Family Therapist | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343 | 2007-08-28 |
1669680609 | Christie Ann Wick | Marriage & Family Therapist | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343-4157 | 2007-05-21 |
1699842138 | John Gregory Luehr | Psychiatry & Neurology | 12301 Whitewater Dr Ste 101, Minnetonka, MN 55343 | 2006-11-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689230542 | Madison C Korus | Behavior Technician | 5501 Feltl Road, Minnetonka, MN 55343 | 2019-05-16 |
1942708508 | Teammd Physicians of Texas Inc | Case Manager/Care Coordinator | 9900 Bren Rd E # 8-b217, Minnetonka, MN 55343 | 2018-01-30 |
1659899284 | Midwest Medical Transit | Transportation Broker | 1001 Main Street #125, Hopkins, MN 55343 | 2017-09-04 |
1376070367 | Noor Translation and Interpretation Services LLC | Interpreter | 5620 Smetana Drive, Ste 300, Office D, Minnetonka, MN 55343 | 2017-05-22 |
1871043240 | Katherine Rae Skarphol | Speech-Language Pathologist | 5501 Feltl Rd, Hopkins, MN 55343 | 2016-10-10 |
1215481478 | Safi Care Transportation | Non-emergency Medical Transport (VAN) | 1001 Mainstreet, Ste 125, Hopkins, MN 55343 | 2016-08-05 |
1649723420 | Stephanie Stackhouse | Internal Medicine | 5520 Bristol Lane, Minnetonka, MN 55343 | 2016-07-28 |
1023479706 | Counter Point Recovery | Substance Abuse Rehabilitation Facility | 5022 Baker Rd, Minnetonka, MN 55343 | 2016-03-09 |
1851766356 | Enrique Mendoza Rojas | Nurse Practitioner | 9900 Ben Road East, Mail Route Mn 008-b213, Minnetonka, MN 55343 | 2015-12-09 |
1013307230 | Susanna Monroe | Nurse Practitioner | Unitedhealth Group Corporate Address, 9900 Bren Road East, Minnetonka, MN 55343 | 2015-01-26 |
Find all providers in zip 55343 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639603541 | Minnetonka Counseling LLC | Psychologist | 12301 Whitewater Dr # 30, Minnetonka, MN 55343-9447 | 2017-04-18 |
1144554858 | Clare N Buntrock | Psychologist | 10275 Wayzata Blvd, #270, Minnetonka, MN 55305-1659 | 2009-09-28 |
1033267612 | Alecia Ann Viera | Psychologist | 10505 Wayzata Blvd Ste 200, Minnetonka, MN 55305-1502 | 2007-01-08 |
1407926363 | Rita A Benak | Psychologist | 11900 Wayzata Blvd Ste 200, Minnetonka, MN 55305-2053 | 2006-11-08 |
1720171382 | Peggy Susan Maki | Psychologist | 601 Carlson Pkwy, Suite 1050, Minnetonka, MN 55305-5203 | 2006-10-02 |
1548370190 | Johanna Lee Lamm | Psychologist | 11812 Wayzata Blvd, Suite 212, Minnetonka, MN 55305-2012 | 2006-08-30 |
1821106279 | Sara Elvabogestad Schilplin | Psychologist | 12301 Whitewater Dr, Ste 101, Minnetonka, MN 55343-9447 | 2006-08-27 |
1386757300 | Jacquelyn K. Wiersma | Psychologist | 3931 Auburn Dr, Minnetonka, MN 55305-5196 | 2006-08-16 |
1053325175 | Susan Kay Powers Olson | Psychologist | 17508 Minnetonka Blvd, Minnetonka, MN 55345-1007 | 2006-07-27 |
1114974201 | The Terrace Group Ltd | Psychologist | 10580 Wayzata Blvd, Ste 150, Minnetonka, MN 55305-1657 | 2006-05-27 |
Find all providers in MINNETONKA |
City | MINNETONKA |
Zip Code | 55343 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.