Lisimba Young

Physical Therapy Assistant · Jackson, MS

Individual Active NPI

NPI number 1174445365

Practice location

969 Lakeland Dr
Jackson, MS 39216-4699
Phone
(601) 200-2000

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NPI record

NPI
1174445365
Entity type
Individual (Type 1)
Enumeration date
July 28, 2026
Last updated
July 28, 2026
Certified
July 28, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 7979 MS
Physical Therapy Assistant 225200000X CP059935A NC

Mailing address

711 Lake Harbour Dr Apt 1010
Ridgeland, MS 39157-4305
Phone
(662) 590-3993

Other practice locations (1)

  • 7277 Veterans Pkwy Ste 208, Raleigh, NC 27603-7528 · (919) 773-4086

About Lisimba Young

Lisimba Young is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 969 Lakeland Dr, Jackson, MS 39216-4699. The NPI number 1174445365 was assigned on July 28, 2026 and the record was last updated on July 28, 2026.

Lisimba Young lists 2 licenses in the registry: #7979 (MS) for Physical Therapy Assistant; #CP059935A (NC) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Lisimba Young?

The NPI number is 1174445365.

What is the phone number of Lisimba Young?

The phone number listed for the practice location is (601) 200-2000.

Where is Lisimba Young located?

969 Lakeland Dr, Jackson, MS 39216-4699.

What is the taxonomy code for Lisimba Young?

The primary taxonomy code is 225200000X – Physical Therapy Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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