Provider Demographics
NPI:1215395751
Name:YOUNG, CAEDY JANAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAEDY
Middle Name:JANAE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAEDY
Other - Middle Name:JANAE YOUNG
Other - Last Name:HILDEBRANDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9600 SW OAK ST STE 500&520
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6583
Mailing Address - Country:US
Mailing Address - Phone:971-364-8069
Mailing Address - Fax:
Practice Address - Street 1:9600 SW OAK ST STE 500&520
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6583
Practice Address - Country:US
Practice Address - Phone:971-364-8069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3704103T00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500694103Medicaid