Kelly Jean Young

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73044792 Issued in NY

Practice address

251 New Karner Rd
Albany, NY 12205-4617

Phone

(518) 258-6374

NPI assigned

Jun 11, 2013

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 names 1

• Ms. Kelly Jean Young Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1427496553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 LASHER RD",
            "city": "SELKIRK",
            "state": "NY",
            "postal_code": "121589587",
            "telephone_number": "518-258-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 NEW KARNER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054617",
            "telephone_number": "518-258-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73044792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "YOUNG",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Adam Young
• Alexandra R Young, AS
• Brett Young, CRNA
• Jaime Lynn Fidler Young, DO
• Jamie Lynn Young, NP
• Pamela Y Young, PA
• Jessica Younger
• Catherine Elizabeth Youngs, RN
• Ryan Youngs, FNP
• Carol Lynn Youtz

• Clinical Social Worker in Albany, NY
• Providers in Albany, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.