Edmund W. Young, EDD, LCSW, MSG, BCD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW21755 Issued in CA

Practice address

11301 Wilshire Blvd.
Building 257 RM. 212
Los Angeles, CA 90073

Phone

(310) 478-3711

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Foothills Psychological Services, Inc.

  • Psychologist
  • Upland, CA
  • NPI 1336121888
  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hollywood, CA
  • NPI 1710102009
  Medicare reassignment NPD
• Blue Moon Senior Counseling of California LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1447678990

  CA

  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Community Health Clinic/Center
  • North Hills, CA
  • NPI 1710370747
  NPD

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1497836670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 GRIFFITH PARK BLVD",
            "address_2": "#303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261063",
            "telephone_number": "323-270-7702",
            "fax_number": "323-666-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD.",
            "address_2": "BUILDING 257 RM. 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90073",
            "telephone_number": "310-478-3711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Griffith Park Blvd",
            "address_2": "#303",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900261063",
            "country_code": "US",
            "telephone_number": "323-270-7702",
            "fax_number": "323-666-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "EDMUND",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "EDD, LCSW, MSG, BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW21755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayleen Jae Gonzales Young, NP
• Deborah Eleanor Young, SOCIAL WORKER
• Denise Sharon Young
• Dominic Young
• Dustin Antwain Young
• Emily Pui-Ming Young
• Ericca Young
• Ericka Hanna Young
• Erika Young, NP
• Garey Faron Young

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.