Kurt Youngberg, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006152 Issued in GA

Practice address

109 Anderson St SE Ste 101
Marietta, GA 30060-8610

Phone

(714) 482-5472

NPI assigned

Oct 12, 2012

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Corner Canyon Counseling

  • Community/Behavioral Health Agency
  • Draper, UT
  • NPI 1114371580
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023360104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 SILVERTHORN DR NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641062",
            "telephone_number": "714-482-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 ANDERSON ST SE STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608610",
            "telephone_number": "714-482-5472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "248 E 13800 S",
            "address_2": "#4",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840205010",
            "country_code": "US",
            "telephone_number": "801-816-1801",
            "fax_number": "801-501-0249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBERG",
        "first_name": "KURT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8375190-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin M Young, DDS, MD
• Linda S Young, CPT
• Madalynn Young
• Tiffany Young
• Treona Young, RBT
• Your Georgia Home Care, LLC
• Emad Youssef, PT
• Youthful Essence MD, LLC
• Frank Yuan, M.D.
• Melissa M Yung, CNM

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.