Ellen Young, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4906C Issued in AL

Practice address

2509 S Vaughan Dr
Mobile, AL 36605-3312

Phone

(251) 454-3664

NPI assigned

Jan 30, 2022

Last updated

Jan 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1578216636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 S VAUGHAN DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366053312",
            "telephone_number": "251-454-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 S VAUGHAN DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366053312",
            "telephone_number": "251-454-3664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Jewel Basin Ct Ste 3D",
            "address_purpose": "LOCATION",
            "city": "Bigfork",
            "state": "MT",
            "postal_code": "599116294",
            "country_code": "US",
            "telephone_number": "406-201-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ELLEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4906C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria York
• Caroline Michelle Young
• Charles D Young, AA
• Chundrekia T Young, RMAMEDICAL ASSISTANT
• Denise Bergeron Young, PT
• Jeffrey Allen Young, DC
• Mary Margaret Young, RPH
• Nicole Patrick Young, CRNP
• Paul H. Young Sr., PHARMD.
• Ronald Gordon Young, DMD

• Clinical Social Worker in Mobile, AL
• Providers in Mobile, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2022; 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.