Individual provider Active NPI

Christopher John Young, LICSW

  • Clinical Social Worker
  • Scituate, MA
National Provider Identifier
1770669350
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105482 Issued in MA
Practice address
132 Front St
Suite 306
Scituate, MA 02066-1386
Phone
(781) 545-1008
Fax
(781) 545-1668
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 105482 MA Primary

Addresses

Primary practice location

132 Front St
Suite 306
Scituate, MA 02066-1386

Mailing address

132 Front St
Suite 306
Scituate, MA 02066-1386
Phone (781) 545-1008

Other identifiers 4

IdentifierTypeStateIssuer
PO3711OtherBLUE CROSS / BLUE SHIELD
459158OtherMATUFTS HEALTH CARE
063521000OtherMAMAGELLAN BEHAVIORAL CARE
839789946OtherUNITED BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040123000254 MA Practitioner - Clinical Social Worker 4284536921 Practice locations: Scituate, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

132 Front St
Scituate, MA 02066-1386
Phone (781) 545-1008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105482MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770669350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 FRONT ST",
            "address_2": "SUITE 306",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020661386",
            "telephone_number": "781-545-1008",
            "fax_number": "781-545-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 FRONT ST",
            "address_2": "SUITE 306",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020661386",
            "telephone_number": "781-545-1008",
            "fax_number": "781-545-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "PO3711",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH CARE",
            "identifier": "459158",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL CARE",
            "identifier": "063521000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "839789946",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scituate, MA

Sources for this page

Verify at the official NPI Registry.