Marilyn Jordan Young, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004886 Issued in NC

Practice address

4000 Blue Ridge Rd
Suite 200
Raleigh, NC 27612-4650

Phone

(919) 782-4981

Fax

(919) 782-2474

NPI assigned

Jan 30, 2007

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freshwinds, Inc

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1861534794
  NPD (past)
• Youth Development Corporation of America

  dba Crabtree Creek Clinic

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1952518110
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275679599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 BLUE RIDGE RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124650",
            "telephone_number": "919-539-0972",
            "fax_number": "919-782-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BLUE RIDGE RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124650",
            "telephone_number": "919-782-4981",
            "fax_number": "919-782-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARILYN",
        "middle_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "138XA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine A Young, M.S. CCC-SLP
• Kelly Young
• Kenlyn Young, RD, LDN
• Lorraine A Young, N.D.
• Maria Cristina Young, MSW, LCSW
• Matthew M Young, MD
• McKenzie Young, LCSW-A
• Melissa Dawn Young, CRT
• Michelle Angela Young
• Natalie Young, PHARMD

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.