Individual provider Active NPI

Rebecca Young, LMHC

  • Mental Health Counselor
  • Charlestown, RI
National Provider Identifier
1528403615
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC00706 Issued in RI
Practice address
4705 Old Post Rd
Charlestown, RI 02813-1841
Phone
(401) 364-7705
Fax
(401) 364-1982
NPI assigned
May 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC00706 RI Primary

Addresses

Primary practice location

4705 Old Post Rd
Charlestown, RI 02813-1841

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: No
  • 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
I20250603004013 RI Practitioner - Mental Health Counselor 4385153030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc CurrentSince Apr 7, 2025 Accepting new patients
South Shore Center Inc Mental Health CurrentSince Apr 7, 2025 Accepting new patients
The Providence Center Inc Mental Health PastSince Jan 21, 2013 Accepting new patients

Locations

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1 Virginia Ave
Ste 200
Providence, RI 02905

24 Salt Pond Rd
Ste H5
Wakefield, RI 02879
Phone (401) 757-6973

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1528403615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 OLD POST RD",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028131841",
            "telephone_number": "401-364-7705",
            "fax_number": "401-364-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REBECCA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, RI

Sources for this page

Verify at the official NPI Registry.