Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083927917 Individual Practitioner Male Practitioner

Dr. Kenneth Ray Young , PsyD, LP

Psychologist • Coon Rapids, MN

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Young, PsyD, LP is a registered healthcare professional specializing in Psychologist in Coon Rapids, MN. Practice services are available at 9055 SPRINGBROOK DR NW under active NPI credentials.

Frequently performed procedures and clinical services include psychotherapy, psychiatric diagnostic evaluation. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

9055 Springbrook Dr Nw

Coon Rapids, MN 554335841

Telephone 7637809155
Fax 7632361066
Associated Practice Facility / Clinic
🏢 Ambor Corporation Facility NPI 1932236130

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Coon Rapids, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.7 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
26 Specialists

Practicing in Coon Rapids, MN (1833 Statewide)

Telehealth Adoption Rate
19.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90832 Psychotherapy, 30 minutes
48 25 $243.77 $74.62
90791 Psychiatric diagnostic evaluation
22 22 $516.03 $171.46

Medical Specialties & State Licenses

CMS Verified: 2023-12-07
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MN LP5036

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.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

State License MN LP5036

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Psychologist - Forensic

NUCC Taxonomy Code: 103TF0200X

State License MN LP5036

A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems.

Psychologist - Clinical Child & Adolescent

NUCC Taxonomy Code: 103TC2200X

State License MN LP5036

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1083927917 (MN)

Secondary Practice Locations

12301 Whitewater Dr Ste 101

Minnetonka, MN 553434157

Phone: 9529996097

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Blythe Nelson , LICSW

Social Worker - Clinical

NPI 1003156761

Licensed Independent Clinical Social Worker

NPI 1003878091

Doctor of Optometry

Dr. Suzanne Witterholt , MD

Psychiatry & Neurology - Pain Medicine

NPI 1013018688

Doctor of Medicine (M.D.)

Dr. Abby Stanislaw , PsyD

Psychologist - Clinical

NPI 1013242536

Doctor of Psychology (Psy.D.)

NPI 1013409523

Doctor of Audiology

Dr. Emily Strange , DPT

Physical Therapist

NPI 1013675487

Doctor of Physical Therapy

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

17 Historical Events
📍
Updated Business Mailing Address December 07, 2023

Registered at 2925 CHICAGO AVE, MINNEAPOLIS, MN 554071321 (Tel: 6122629000)

📍
Updated Practice Location September 22, 2023

Registered at 9055 SPRINGBROOK DR NW, COON RAPIDS, MN 554335841 (Tel: 7637809155)

NPI Profile Active December 04, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location December 04, 2017

Registered at 12301 WHITEWATER DR STE 101, MINNETONKA, MN 553434157 (Tel: 9529996097)

📍
Updated Business Mailing Address December 04, 2017

Registered at 12301 WHITEWATER DR STE 101, MINNETONKA, MN 553434157 (Tel: 9529996097)

👤
Provider Name / Credentials Updated December 04, 2017

Recorded as KENNETH YOUNG, PSYD, LP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 04, 2017

Psychologist (License #LP5036 in MN)

📍
Updated Practice Location February 08, 2017

Registered at 12301 WHITEWATER DR, STE 101, MINNETONKA, MN 553439447 (Tel: 9529996097)

📍
Updated Business Mailing Address February 08, 2017

Registered at 2014 OMEGA DR, SHAKOPEE, MN 553795402 (Tel: 9522885353)

👤
Provider Name / Credentials Updated February 08, 2017

Recorded as KENNETH YOUNG, PSYD, LP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2017

Psychologist (License #LP5036 in MN)

NPI Profile Active July 20, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location July 20, 2010

Registered at 825 NICOLLET MALL, 1735 MEDICAL ARTS BUILDING, MINNEAPOLIS, MN 554022606 (Tel: 9522885353)

📍
Updated Business Mailing Address July 20, 2010

Registered at 825 NICOLLET MALL, 1735 MEDICAL ARTS BUILDING, MINNEAPOLIS, MN 554022606 (Tel: 9522885353)

👤
Provider Name / Credentials Updated July 20, 2010

Recorded as KEN YOUNG, PSYD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2010

Psychologist (License #LP5036 in MN)

🟢
Initial NPI Registration & Enumeration July 20, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1083927917
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2010
Last Update: December 07, 2023
Sole Proprietor: No

Mailing Address

2925 Chicago Ave

Minneapolis, MN 554071321

Phone: 6122629000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.