Individual provider Active NPI

Anna Catherine Tickner-Young, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1740966670
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12312-123
Practice address
700 Rayovac Dr #103
Madison, WI 53711-2468
Phone
(608) 238-5826
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12312-123 Primary

Addresses

Primary practice location

700 Rayovac Dr #103
Madison, WI 53711-2468

Mailing address

700 Rayovac Dr #103
Madison, WI 53711-2468
Phone (608) 238-5826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20250725003401 WI Practitioner - Clinical Social Worker 3779090667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regent Mental Health Group SCGroup PAC ID 5294053112, 17 clinicians

Practice addresses (Care Compare)

700 Ray O Vac Dr
Suite 103
Madison, WI 53711-2468
Phone (608) 238-5826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regent Mental Health Group SC CurrentSince Jun 17, 2025 Accepting new patients

Locations

700 Ray O Vac Dr
Ste 103
Madison, WI 53711
Phone (608) 238-5826

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1740966670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RAYOVAC DR #103",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112468",
            "telephone_number": "608-238-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAYOVAC DR #103",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112468",
            "telephone_number": "608-238-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKNER-YOUNG",
        "first_name": "ANNA",
        "middle_name": "CATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "12312-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.