Active NPI
Kathy Young
- Social Worker
- Cranston, RI
National Provider Identifier
1013339589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- CSW02109.
- Practice address
- 1471 Elmwood Ave
Cranston, RI 02910-3849 - Phone
- (401) 724-8400
- Fax
- (401) 722-5280
- NPI assigned
- Jan 17, 2014
- Last updated
- Sep 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Social Worker | 104100000X | CSW02109. | RI | Primary |
Addresses
Primary practice location
1471 Elmwood Ave
Cranston, RI 02910-3849
Mailing address
315 Northup St
Cranston, RI 02905-4205
Phone (401) 548-6130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH57134 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW02109. | RI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center | Past | Accepting new patients | |
| Gateway Healthcare Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
-
- Community/Behavioral Health Agency
- Providence, RI
- NPI 1134977598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1013339589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 NORTHUP ST",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029054205",
"telephone_number": "401-548-6130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1471 ELMWOOD AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029103849",
"telephone_number": "401-724-8400",
"fax_number": "401-722-5280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "KATHY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-17",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "CSW02109.",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GH57134",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.