Active NPI
Rebecca-Jo Salunek Young, LCSW, ADC
- Clinical Social Worker
- Norfolk, VA
National Provider Identifier
1619052958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904003538
- Practice address
- 225 W Olney Rd
Norfolk, VA 23510-1534 - Phone
- (757) 823-1600
- Fax
- (757) 823-1601
- NPI assigned
- Oct 26, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904003538 | VA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 06000911A | VA |
Addresses
Primary practice location
225 W Olney Rd
Norfolk, VA 23510-1534
Mailing address
PO Box 8794
Norfolk, VA 23503-0794
Phone (757) 705-8620
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O83896 | Other | VA | OPTIMA |
| 004945395 | Medicaid | VA | |
| 285589 | Other | VA | ANTHEM |
| 004945395 | Other | VA | VA PREMIER |
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 |
|---|---|---|---|
| 06000911A | VA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367971200000",
"number": "1619052958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8794",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235030794",
"telephone_number": "757-705-8620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 W OLNEY RD",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235101534",
"telephone_number": "757-823-1600",
"fax_number": "757-823-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "REBECCA-JO",
"middle_name": "SALUNEK",
"credential": "LCSW, ADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2013-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904003538",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "VA",
"license": "06000911A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA",
"identifier": "O83896",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004945395",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "285589",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA PREMIER",
"identifier": "004945395",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.