Active NPI
Abby Young, LSCSW
- Clinical Social Worker
- Lawrence, KS
National Provider Identifier
1346639804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4842
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201107170A | Medicaid | KS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4842 | KS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Clinical Social Worker
- Lawrence, KS
- NPI 1427520931
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.