Active NPI
Shunita Simone Young, LMSW, LCSW
- Clinical Social Worker
- Conroe, TX
National Provider Identifier
1609817345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 52597
- Practice address
- 510 Billie Bess LN
Apt 116
Conroe, TX 77301-1303 - Phone
- (936) 718-6807
- NPI assigned
- Jun 10, 2006
- Last updated
- May 3, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1887-M | AR | |
| Clinical Social Worker | 1041C0700X | 52597 | TX | Primary |
Addresses
Primary practice location
510 Billie Bess LN
Apt 116
Conroe, TX 77301-1303
Mailing address
510 Billie Bess LN
Apt 116
Conroe, TX 77301-1303
Phone (936) 718-6807
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1887-M | AR | MD | Mental Health Counselor |
| 52597 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272844800000",
"number": "1609817345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 BILLIE BESS LN",
"address_2": "APT 116",
"city": "CONROE",
"state": "TX",
"postal_code": "773011303",
"telephone_number": "936-718-6807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 BILLIE BESS LN",
"address_2": "APT 116",
"city": "CONROE",
"state": "TX",
"postal_code": "773011303",
"telephone_number": "936-718-6807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "SHUNITA",
"middle_name": "SIMONE",
"name_prefix": "Miss",
"credential": "LMSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-10",
"last_updated": "2010-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "1887-M",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "52597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.