NPI Details
DR. Kenneth Ray Young, PSYD, LP is a psychologist in Coon Rapids, MN. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. DR. Kenneth Ray Young, PSYD, LP NPI is 1083927917. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
9055 SPRINGBROOK DR NW
COON RAPIDS, MN
ZIP 55433-841
Phone: (763) 780-9155
Fax: (763) 236-1066
The NPI 1083927917 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Psychotherapy, 30 minutes (HCPCS:90832)
- Psychiatric diagnostic evaluation (HCPCS:90791)
The enumeration date for this NPI number is 7/20/2010 and was last updated on 12/7/2023.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103TC0700X | Psychologist | Clinical | LP5036 | MINNESOTA | No |
| 2 | 103TF0200X | Psychologist | Forensic | LP5036 | MINNESOTA | No |
| 3 | 103T00000X | Psychologist | | LP5036 | MINNESOTA | Yes |
| 4 | 103TC2200X | Psychologist | Clinical Child & Adolescent | LP5036 | MINNESOTA | No |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 1083927917 | MEDICAID | MINNESOTA | |
