Individual provider Active NPI

Abby Young, LSCSW

  • Clinical Social Worker
  • Lawrence, KS
National Provider Identifier
1346639804
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4842 Issued in KS
Practice address
512 E 9TH St Ste B
Lawrence, KS 66044-2679
Phone
(785) 393-2541
Fax
(785) 393-2541
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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 4842 KS Primary

Addresses

Primary practice location

512 E 9TH St Ste B
Lawrence, KS 66044-2679

Mailing address

434 Perry St
Lawrence, KS 66044-1561
Phone (785) 393-2541

Other identifiers 1

IdentifierTypeStateIssuer
201107170AMedicaidKS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4842KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tillery Time Consulting Clinical Current Accepting new patients

Locations

512 E 9th St
Ste B
Lawrence, KS 66044
Phone (785) 393-2541

Organizations & group practices 1

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": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1346639804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 PERRY ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441561",
            "telephone_number": "785-393-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 E 9TH ST STE B",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442679",
            "telephone_number": "785-393-2541",
            "fax_number": "785-393-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ABBY",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201107170A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.