Shkethia Andrea Young, MSW,LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P006366 Issued in NC

Practice address

8619 Oak Dr NE
Charlotte, NC 28269-1650

Phone

(704) 208-0742

NPI assigned

Nov 8, 2012

Last updated

Nov 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Little-Gerald Services

  • Community/Behavioral Health Agency
  • Monroe, NC
  • NPI 1093114670
  Medicare reassignment

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1710231055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 OAK DR NE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691650",
            "telephone_number": "704-208-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 OAK DR NE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691650",
            "telephone_number": "704-208-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SHKETHIA",
        "middle_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "MSW,LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P006366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reggie Young III
• Robert L Young Jr., DDS
• Scott A Young, DDS
• Shannon Brooke Young, CRNA
• Sharon Young, LPCA
• Sirena Young, M.S., BCBA, NC-LBA
• Susan Luke Young, LCSW
• Tarica Nicole Young, OTR/L
• Tessa Young
• Tiffany Young, M.ED,LPCA,NCC,NCCSC

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.