Provider Demographics
NPI:1427484120
Name:YOUNG, JILL LESLIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:LESLIE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 S ROSEMARY WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1348
Mailing Address - Country:US
Mailing Address - Phone:720-560-8622
Mailing Address - Fax:303-843-9778
Practice Address - Street 1:1660 S ALBION ST
Practice Address - Street 2:SUITE 408
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4008
Practice Address - Country:US
Practice Address - Phone:720-560-8622
Practice Address - Fax:303-843-9778
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1864103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical