Individual provider Active NPI

Richard Charles Young, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1063781631
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2006022838 Issued in MO
Practice address
2025 S Brentwood Blvd
Saint Louis, MO 63144-1833
Phone
(314) 550-2251
NPI assigned
Dec 27, 2011
Last updated
Dec 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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 2006022838 MO Primary

Addresses

Primary practice location

2025 S Brentwood Blvd
Saint Louis, MO 63144-1833

Mailing address

4124 Robert Ave
Saint Louis, MO 63116-2742
Phone (314) 550-2251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20120522000849 MO Practitioner - Clinical Social Worker 9537322987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

412 S Clay Ave
Suite 200
Saint Louis, MO 63122-5860
Phone (314) 550-2251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006022838MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard C Young LCSW Inc CurrentSince May 24, 2014 Accepting new patients
Residential Psychiatric Services, Inc. Clinical PastSince Jun 12, 2012 Accepting new patients

Locations

412 S Clay Ave
Ste 200
Saint Louis, MO 63122
Phone (314) 550-2251

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.

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1063781631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 ROBERT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162742",
            "telephone_number": "314-550-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S BRENTWOOD BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441833",
            "telephone_number": "314-550-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "RICHARD",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006022838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.