Individual provider Active NPI

Kimberley Young

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1033566070
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009343 Issued in VA
Practice address
107 S 5TH St
Richmond, VA 23219-3825
Phone
(804) 819-4000
Fax
(804) 819-5221
NPI assigned
May 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009343 VA Primary

Addresses

Primary practice location

107 S 5TH St
Richmond, VA 23219-3825

Mailing address

107 S 5TH St
Richmond, VA 23219-3825
Phone (804) 819-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160701000636 VA Practitioner - Clinical Social Worker 8224320734 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Behavioral Health Authority CurrentSince May 24, 2016 Accepting new patients

Locations

107 S 5th St
Richmond, VA 23219
Phone (804) 819-4000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1033566070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KIMBERLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.