Individual provider Active NPI

Destin Michael Yonge, LCSW

  • Clinical Social Worker
  • Baton Rouge, LA
National Provider Identifier
1245084904
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15750 Issued in LA
Practice address
3401 North Blvd Ste 100
Baton Rouge, LA 70806-3743
Phone
(225) 381-2621
Fax
(225) 381-2737
NPI assigned
Apr 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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 15750 LA Primary

Addresses

Primary practice location

3401 North Blvd Ste 100
Baton Rouge, LA 70806-3743

Mailing address

7373 Perkins Rd
Baton Rouge, LA 70808-4373
Phone (225) 246-9790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20240501000214 LA Practitioner - Clinical Social Worker 5890135354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baton Rouge Clinic, a Medical CorporationGroup PAC ID 1254317001, 285 clinicians

Practice addresses (Care Compare)

3401 N Blvd
Baton Rouge, LA 70806-3743
Phone (225) 381-2621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15750LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation CurrentSince May 1, 2024 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince May 1, 2024 Accepting new patients

Locations

3401 North Blvd
Ste 100
Baton Rouge, LA 70806
Phone (225) 381-2621

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1245084904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084373",
            "telephone_number": "225-246-9790",
            "fax_number": "225-246-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 NORTH BLVD STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063743",
            "telephone_number": "225-381-2621",
            "fax_number": "225-381-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONGE",
        "first_name": "DESTIN",
        "middle_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "15750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.