Teresa Youngberg, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-30135 Issued in ID

Practice address

1111 S Orchard St Ste 245
Boise, ID 83705-1964

Phone

(208) 867-9403

NPI assigned

Oct 12, 2021

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)

Not enrolled

State licenses

Practice roles

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.

• Uzima Health Services LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1720691249

  Social Worker

  NPD
• Children'S Home Society of Idaho

  • Mental Health Counselor
  • Boise, ID
  • NPI 1194834010
  NPD (past)

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1629730171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S ORCHARD ST STE 245",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051964",
            "telephone_number": "208-867-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S ORCHARD ST STE 245",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051964",
            "telephone_number": "208-867-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBERG",
        "first_name": "TERESA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-30135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler David Young
• Stephen Paul Young, PHARMD
• Tauna Marie Young, NP
• Taylor Young, PHARMD
• Tracy M Young, FNP
• Eileen Youngblood, AGPCNP-C
• Jodee L Youngblood
• Scott Bradley Youngblood
• Elissa Jean-Marie Youngbluth, L.M.T.
• Cheryl L Youngsman, CRNA

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.