Individual provider Active NPI

Jonathan Davis Young, CSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1770337487
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256453 Issued in KY
Practice address
1718 Sharkey Way Ste 200
Lexington, KY 40511-2028
Phone
(317) 659-0002
NPI assigned
Apr 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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 256453 KY Primary

Addresses

Primary practice location

1718 Sharkey Way Ste 200
Lexington, KY 40511-2028

Mailing address

603 Hunters Ridge Dr
Versailles, KY 40383-1667

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

LicenseStateTypeSpecialty
256453KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1770337487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 HUNTERS RIDGE DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SHARKEY WAY STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112028",
            "telephone_number": "317-659-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JONATHAN",
        "middle_name": "DAVIS",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.