DR. KENNETH RAY YOUNG JR. PSYD, LP
NPI 1083927917
Psychologist in Coon Rapids, MN

Active since July 20, 2010PECOS Enrolled
83.53/100
CMS Quality Rating
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433(763) 780-9155(763) 236-1066 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 7, 2023, Dec 4, 2017, Feb 8, 2017 (3 updates tracked since 2017).

About Dr. Kenneth Ray Young Jr. Psyd, Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH RAY YOUNG JR. PSYD, LP (NPI 1083927917) is an individual psychologist in Coon Rapids, Minnesota, licensed in Minnesota (LP5036) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS and maintains a secondary practice location in Minnetonka.

NPPES Registry Identity

NPI1083927917
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. KENNETH RAY YOUNG JR.Credential: PSYD, LP
Location Address9055 SPRINGBROOK DR NWCoon Rapids, MN 55433-5841
Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000
Fax(763) 236-1066
Sole ProprietorNo
Enumeration DateJuly 20, 2010
Last NPPES UpdateDecember 7, 20233 updates tracked since enumeration
NPPES CertifiedDecember 7, 2023
NPI 1083927917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP5036
Definition
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.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License LP5036 (MN)
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License LP5036 (MN)
Also ListedPsychologist · ForensicTaxonomy 103TF0200X · License LP5036 (MN)
9055 SPRINGBROOK DR NW, Coon Rapids, MN 55433

Secondary Practice Location 1

Location 112301 Whitewater Dr Ste 101Minnetonka, MN 55343-4157 · Phone (952) 999-6097 · Fax (952) 426-0508

Other Identifiers 1

Medicaid1083927917MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Kenneth Ray Young Jr. Psyd, Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.79
Promoting Interoperability100
Improvement Activities40
Cost63.31

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Psychiatry & Neurology (Pain Medicine)
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Psychologist (Clinical)
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Audiologist
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Physical Therapist
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Family Medicine
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Internal Medicine
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Dietitian, Registered
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Young's NPI number?

The NPI number for Kenneth Young is 1083927917. It was assigned to this individual provider in the NPPES registry on July 20, 2010.

Where is Kenneth Young located?

Kenneth Young practices at 9055 Springbrook Dr NW, Coon Rapids, MN 55433. The listed phone number is (763) 780-9155.

What is Kenneth Young's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kenneth Young enrolled in Medicare?

Yes. Kenneth Young is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Young was last updated on December 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.