Individual provider Active NPI

Gina Young, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1649614553
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L14037 Issued in OR
Practice address
8555 SW Apple Way Ste 320
Portland, OR 97225-1775
Phone
(877) 840-6956
Fax
(619) 383-6701
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 54624 TX
Clinical Social Worker 1041C0700X L14037 OR Primary

Addresses

Primary practice location

8555 SW Apple Way Ste 320
Portland, OR 97225-1775

Mailing address

PO Box 601422
San Diego, CA 92160-1422
Phone (877) 840-6956

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

LicenseStateTypeSpecialty
L14037ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transponder Clinical Current Accepting new patients
Montrose Counseling Center, Inc. Past Accepting new patients
The Montrose Center Clinical PastSince Jun 20, 1996 Accepting new patients
Vcounselors PLLC PastSince May 16, 2022 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1649614553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601422",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921601422",
            "telephone_number": "877-840-6956",
            "fax_number": "619-383-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 SW APPLE WAY STE 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251775",
            "telephone_number": "877-840-6956",
            "fax_number": "619-383-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54624",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L14037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.