Active NPI
Charles A Young Jr., MSW, LSW
- Social Worker
- Savoy, IL
National Provider Identifier
1508685397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.111357
- Practice address
- 1806 Woodfield Dr Ste 105
Savoy, IL 61874-9505 - Phone
- (217) 766-0258
- NPI assigned
- Oct 8, 2024
- Last updated
- Oct 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.111357 | IL | Primary |
Addresses
Primary practice location
1806 Woodfield Dr Ste 105
Savoy, IL 61874-9505
Mailing address
2514 Sangamon Dr
Champaign, IL 61821-4756
Phone (217) 418-1436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.111357 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1508685397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2514 SANGAMON DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618214756",
"telephone_number": "217-418-1436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1806 WOODFIELD DR STE 105",
"city": "SAVOY",
"state": "IL",
"postal_code": "618749505",
"telephone_number": "217-766-0258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "CHARLES",
"middle_name": "A",
"name_suffix": "Jr.",
"credential": "MSW, LSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-08",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.111357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savoy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.