Active NPI
Charlene K Young, COTA/L
- Occupational Therapy Assistant
- Jersey Shore, PA
National Provider Identifier
1598916702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OP001310L
- Practice address
- 2921 Rauchtown Rd
Jersey Shore, PA 17740-7254 - Phone
- (570) 323-3758
- NPI assigned
- Oct 7, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OP001310L | PA | Primary |
Addresses
Primary practice location
2921 Rauchtown Rd
Jersey Shore, PA 17740-7254
Mailing address
2921 Rauchtown Rd
Jersey Shore, PA 17740-7254
Phone (570) 323-3758
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 |
|---|---|---|---|
| OP001310L | PA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1598916702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2921 RAUCHTOWN RD",
"city": "JERSEY SHORE",
"state": "PA",
"postal_code": "177407254",
"telephone_number": "570-323-3758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2921 RAUCHTOWN RD",
"city": "JERSEY SHORE",
"state": "PA",
"postal_code": "177407254",
"telephone_number": "570-323-3758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "CHARLENE",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-07",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "PA",
"license": "OP001310L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey Shore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.