Jedonna Young IV

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801080495 Issued in MI

Practice address

17421 Telegraph Rd
Detroit, MI 48219-3165

Phone

(313) 531-2500

NPI assigned

May 30, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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 and National Provider Directory roles.

• Maverick'S Transportation Service, LLC

  • Non-emergency Medical Transport (VAN)
  • Roseville, MI
  • NPI 1285273029
  NPD (past)

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1215195805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17421 TELEGRAPH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17421 TELEGRAPH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193165",
            "telephone_number": "313-531-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEDONNA",
        "name_suffix": "IV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801080495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Catherine Young
• Erroll Conway Young, LBSW
• Georgia G Young, CRNA
• India Nicole Young, LLMSW
• Jay Andre Young Sr.
• Jeffrey Alan Young, PAC
• Jennifer Lynn Young, FNP-C
• Karlita Young
• Kenetra Young, PHD
• Lance Young

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.