JACQUELINE JAYDE YOUNG (NPI# 1629442900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629442900 |
| Entity Type | Individual |
| Full Name | JACQUELINE JAYDE YOUNG |
| Credential | LPC |
| Practice Address |
4516 Boat Club Rd Ste 106 Fort Worth TX 76135-7020 |
| Practice Telephone | 8172380106 |
| Practice Fax Number | 8172388333 |
| Mailing Telephone | 8172380106 |
| Mailing Fax Number | 8172388333 |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
72131 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184125585 | Jacqueline H Young | Student in an Organized Health Care Education/Training Program | 8001 S Us Highway 75 # 75, Sherman, TX 75090-5707 | 2018-02-22 |
| 1508087768 | Jacqueline Leanne Young | Speech-Language Pathologist | 411 Madison, Webb City, MO 64870 | 2007-05-02 |
| 1013369966 | Jacqueline Lee Young | Community/Behavioral Health | 1240 116th Ave Ne, Bellevue, WA 98004-3815 | 2016-07-04 |
| 1548622954 | Jacqueline Young | Counselor | 1636 N Hampton Rd, Ste 101, Desoto, TX 75115-8621 | 2016-03-24 |
| 1972923050 | Jacqueline Young | Internal Medicine | 10051 5th St N Ste 200, St Petersburg, FL 33702-2211 | 2014-04-16 |
| 1538408109 | Jacqueline R Young | Counselor | 3931 Trueman Blvd, Hilliard, OH 43026-2495 | 2013-02-02 |
| 1982995452 | Jacqueline Marie Young | Physical Therapist | 115 Academy Ave, Greenwood, SC 29646-3869 | 2011-05-02 |
| 1013246172 | Jacqueline Marie Young | Nurse Anesthetist, Certified Registered | 3229 Burnet Ave, Cincinnati, OH 45229-3018 | 2009-12-18 |
| 1053510867 | Jacqueline Young | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2007-07-12 |
| 1194923516 | Jacqueline Young | Counselor | 215 Shelburne Rd, Greenfield, MA 01301-9622 | 2007-07-06 |
| Street Address |
4516 BOAT CLUB RD STE 106 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76135-7020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245463926 | Guadalupe Garcia | Counselor | 4516 Boat Club Rd Ste 106, Fort Worth, TX 76135-7020 | 2009-08-28 |
| 1801301189 | Emily Wallen | Counselor | 4516 Boat Club Rd Ste 106, Fort Worth, TX 76135-7020 | 2017-12-07 |
| 1225481146 | Jackie Manivanh | Counselor | 4516 Boat Club Rd Ste 106, Fort Worth, TX 76135-7020 | 2016-07-15 |
| 1962650259 | Susan Schlosser | Marriage & Family Therapist | 4516 Boat Club Rd Ste 106, Fort Worth, TX 76135-7020 | 2008-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992283501 | Sung Ryel Choi | Dentist | 6014 Azle Ave # 100, Lake Worth, TX 76135 | 2018-08-06 |
| 1750882056 | Kandess Klein | Licensed Vocational Nurse | 8825 Claiborn St, Lakeside, TX 76135 | 2018-02-22 |
| 1841791258 | Robyn Rich | Technician | 5104 Prestwick Drive, Fort Worth, TX 76135 | 2018-02-22 |
| 1598207821 | Young Men's Christian Association of Metropolitan Fort Worth | Health Educator | 5315 Boat Club Rd, Fort Worth, TX 76135 | 2016-11-17 |
| 1558818534 | Clearfork Academy Lp | Substance Abuse Rehabilitation Facility | 7820 Hanger Cut Off, Fort Worth, TX 76135 | 2016-09-07 |
| 1316300999 | National Vision, Inc. | Technician/Technologist | 6014 Azle Ave, Ste 200, Lake Worth, TX 76135 | 2016-04-01 |
| 1457647570 | Cynthia Rosaline Witt | Optometrist | 6014 Azle Avenue, Suite 300, Lake Worth, TX 76135 | 2011-06-27 |
| 1316134125 | Home Town Dental,pa | Dentist | 6332 Lake Worth, Lake Worth, TN 76135 | 2007-09-26 |
| 1790984789 | Jonathan Nicholas Valamides | Optometrist | 6060 Azle Ave. Suite 500, Lake Worth, TX 76135 | 2007-07-11 |
| 1457570053 | Dawn Denise Ezelle | Occupational Therapy Assistant | 3400 Marine Drive, Fort Worth, TX 76135 | 2007-04-24 |
| Find all providers in zip 76135 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003428780 | Cynthia Frazier | Counselor | 2612 Dahlia Dr, Fort Worth, TX 76123-1252 | 2020-08-23 |
| 1326650755 | Next Steps Professional Counseling Services, LLC | Counselor | 101 S Jennings Ave Unit 104, Fort Worth, TX 76104-1112 | 2020-08-18 |
| 1477163103 | Adriana E Speiker | Counselor | 3509 Hulen St Ste 251, Fort Worth, TX 76107-6867 | 2020-08-07 |
| 1285252031 | Kiersta Lane Garcia | Counselor | 1810 8th Ave Ste B204, Fort Worth, TX 76110-1352 | 2020-07-08 |
| 1588290571 | Heather Penry | Counselor | 1024 Marlow Ln, Fort Worth, TX 76131-5375 | 2020-03-21 |
| 1992339105 | Azmeh Amer | Counselor | 172 Saint Donovan St, Fort Worth, TX 76107-1252 | 2020-02-26 |
| 1588297121 | Surnedra C Simmons | Counselor | 4941 Sunset Ridge Dr, Fort Worth, TX 76123-4615 | 2020-02-21 |
| 1821629957 | Turquoise Banks | Counselor | 5821 Wedgwood Dr, Fort Worth, TX 76133-2726 | 2020-01-28 |
| 1003447236 | Nicole Leona Sallee | Counselor | 201 Main St Fl 6, Fort Worth, TX 76102-3105 | 2020-01-27 |
| 1780214106 | Jeremy Adam Lelek | Counselor | 2501 Parkview Dr Ste 220, Fort Worth, TX 76102-5824 | 2020-01-24 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76135 |
Please comment or provide details below to improve the information on JACQUELINE JAYDE YOUNG.
| 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.