Active NPI
Kathleen Young
- Clinical Social Worker
- Minot Afb, ND
National Provider Identifier
1720467293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW - 954
- Practice address
- 10 Missile Ave
Minot Afb, ND 58705-5003 - Phone
- (701) 723-5087
- NPI assigned
- May 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PCSW-621 | WY | |
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | LCSW - 954 | WY | Primary |
Addresses
Primary practice location
10 Missile Ave
Minot Afb, ND 58705-5003
Mailing address
Unit 33100
Apo, AE 09180-3100
Other practice location 1
90 Hope Dr Bldg 6000
Mountain Home AFB, ID 83648-1062
Phone (208) 828-7580
Other practice location 2
Unit 33100
Apo, AE 09180-3100
Phone (151) 688-2115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCSW954 | Other | WY | LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCSW-621 | WY | MD | Mental Health Counselor |
| LCSW - 954 | WY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1720467293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "UNIT 33100",
"city": "APO",
"state": "AE",
"postal_code": "091803100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MISSILE AVE",
"city": "MINOT AFB",
"state": "ND",
"postal_code": "587055003",
"telephone_number": "701-723-5087"
}
],
"practiceLocations": [
{
"address_1": "90 Hope Dr Bldg 6000",
"address_purpose": "LOCATION",
"city": "Mountain Home AFB",
"state": "ID",
"postal_code": "836481062",
"country_code": "US",
"telephone_number": "208-828-7580",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Unit 33100",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AE",
"postal_code": "091803100",
"country_code": "US",
"telephone_number": "151-688-2115",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "KATHLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-29",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "PCSW-621",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WY",
"license": "LCSW - 954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "LCSW954",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minot Afb, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.