Active NPI
John C Young, LISW
- Social Worker
- Barnwell, SC
National Provider Identifier
1306912530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1004
- Practice address
- 86 Wren St
Barnwell, SC 29812-1529 - Phone
- (803) 259-5762
- Fax
- (803) 259-3250
- NPI assigned
- Nov 28, 2006
- Last updated
- Feb 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1004 | SC | Primary |
Addresses
Primary practice location
86 Wren St
Barnwell, SC 29812-1529
Mailing address
120 Live Oak LN
Barnwell, SC 29812-7428
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004 | Other | SC | MEDICAL LICENSE |
| SW1311 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1004 | SC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1306912530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 LIVE OAK LN",
"city": "BARNWELL",
"state": "SC",
"postal_code": "298127428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 WREN ST",
"city": "BARNWELL",
"state": "SC",
"postal_code": "298121529",
"telephone_number": "803-259-5762",
"fax_number": "803-259-3250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JOHN",
"middle_name": "C",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2023-02-27",
"certification_date": "2023-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": "1004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "1004",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SW1311",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barnwell, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.