Individual provider Active NPI

Melissa Lynn Young, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1386767333
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-27329 Issued in ID
Practice address
6140 W Emerald St
Boise, ID 83704-8857
Phone
(208) 367-3300
Fax
(208) 367-3308
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 LCSW-27329 ID Primary

Addresses

Primary practice location

6140 W Emerald St
Boise, ID 83704-8857

Mailing address

6140 W Emerald St
Boise, ID 83704-8857
Phone (208) 367-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629003618 ID Practitioner - Clinical Social Worker 5799165288 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-27329IDMDClinical Social Worker
1902KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Clinical Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2024 Accepting new patients
Safe Connections, LLC. Clinical CurrentSince Mar 3, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2024 Accepting new patients
Tanta Inc Clinical PastSince Nov 24, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Past Accepting new patients

Locations

7285 W Franklin Rd
Boise, ID 83709
Phone (208) 853-5095

413 W Idaho St
Ste 302
Boise, ID 83702
Phone (208) 333-8333

6140 W Emerald St
Boise, ID 83704
Phone (208) 367-3300

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Organizations & group practices 6

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1386767333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048857",
            "telephone_number": "208-367-3300",
            "fax_number": "208-367-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048857",
            "telephone_number": "208-367-3300",
            "fax_number": "208-367-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-27329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.