Individual provider Active NPI

Erika Charrell Albertie-Young, LCSW

  • Clinical Social Worker
  • Lady Lake, FL
National Provider Identifier
1508530668
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16510 Issued in FL
Practice address
989 S US Highway 27
Lady Lake, FL 32159-5239
Phone
(904) 415-9090
NPI assigned
Aug 3, 2021
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 16510 FL Primary

Addresses

Primary practice location

989 S US Highway 27
Lady Lake, FL 32159-5239

Mailing address

989 S US Highway 27
Lady Lake, FL 32159-5239

Other names 1

  • Erika Charrell Albertie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210825000234 FL Practitioner - Clinical Social Worker 2668877937 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

22385 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone (904) 404-8641

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16510FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Community Health Services, Inc. CurrentSince Dec 1, 2024 Accepting new patients
MCR Health, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Balanced Wellbeing LLC Clinical CurrentSince Aug 1, 2021 Accepting new patients
MCR Health, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Coastal Community Health Services, Inc. CurrentSince Dec 1, 2024 Accepting new patients

Locations

22385 Flora Parke Xing
Fernandina Beach, FL 32034
Phone (904) 404-8641

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

106 Shoppers Way
Ste 101
Brunswick, GA 31525
Phone (912) 275-8208

1022 Miller Ln SW
Darien, GA 31305
Phone (912) 257-8028

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1508530668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 S US HIGHWAY 27",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 S US HIGHWAY 27",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595239",
            "telephone_number": "904-415-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERTIE-YOUNG",
        "first_name": "ERIKA",
        "middle_name": "CHARRELL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "16510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "ALBERTIE",
            "middle_name": "CHARRELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.