Individual provider Active NPI

Marlon Young, PH.D, L.C.S.W, M.P.A

  • Clinical Psychologist
  • Hawthorne, CA
National Provider Identifier
1174897714
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21424 Issued in CA
Practice address
2311 W El Segundo Blvd
Hawthorne, CA 90250-3315
Phone
(323) 241-6730
NPI assigned
Feb 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 21289 CA
Clinical Psychologist 103TC0700X PSY21424 CA Primary

Addresses

Primary practice location

2311 W El Segundo Blvd
Hawthorne, CA 90250-3315

Mailing address

2658 Griffith Park Blvd # 358
Los Angeles, CA 90039-2520
Phone (323) 428-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130326000623 CA Practitioner - Clinical Psychologist 8426293283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

1045 W Redondo Beach Blvd
Gardena, CA 90247-4128
Phone (323) 241-6730

2311 W El Segundo Blvd
South Bay MHS
Hawthorne, CA 90250-3315
Phone (310) 241-6730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCS 21289CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Feb 9, 2013 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Feb 9, 2013 Accepting new patients

Locations

2311 W El Segundo Blvd
Hawthorne, CA 90250
Phone (310) 241-6730

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 3

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1174897714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 GRIFFITH PARK BLVD # 358",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392520",
            "telephone_number": "323-428-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 W EL SEGUNDO BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503315",
            "telephone_number": "323-241-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARLON",
        "name_prefix": "Dr.",
        "credential": "PH.D, L.C.S.W, M.P.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-29",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 21289",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.