Jonique Young

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019789 Issued in IL

Practice address

200 Hensley Ave BLDG 1670
Fort Worth, TX 76127-1040

Phone

(817) 852-3295

NPI assigned

Dec 15, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1417616574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENSLEY AVE BLDG 1620",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761271040",
            "telephone_number": "817-709-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENSLEY AVE BLDG 1670",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761271040",
            "telephone_number": "817-852-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JONIQUE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MILITARY/ FEDERAL WORKER",
            "identifier": "149019789",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonique.young.2@us.af.mil",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 Hensley Ave Bldg 1670",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761271040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacqueline Jayde Young, LPC
• James Robert Young, PH.D.
• Jasmin Young, AGNP-C
• Jenna Young
• John G Young, MD
• Kandace Young
• Katie Young, M.S.,CCC-SLP
• Kristin Michelle Young, OT
• Kylie Young
• Lori Lynn Young, MS, CCC-SLP

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.