D'Netra Latrice Young-Lawal, LCSW
Individual provider Active NPI Clinical Social Worker · Jeffersonville, GA
NPI 1265906960 · NPPES record last updated Jan 29, 2021
Key facts
- NPI
- 1265906960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW007457 (GA)
- Practice address
- 224 Main St
Jeffersonville, GA 31044-3642 - Phone
- (478) 957-6283
- NPI assigned
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW007080 | GA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- dnetrayounglawal@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW007457 | GA | Yes |
| Social Worker | 104100000X | MSW007080 | GA |
Addresses
Primary practice location
224 Main St
Jeffersonville, GA 31044-3642
Mailing address
224 Main St
Jeffersonville, GA 31044-3642
Phone (478) 957-6283
Other providers in Jeffersonville, GA
- Crystal Stephens
- Twiggs County Public Schools
- Twiggs Department of Public Health
- Mitzi Weekley
- Juliette Herrington Williams
All providers in Jeffersonville, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.