Tina Young LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TINA YOUNG LCSW PLLC

Practice address

817 Broad St
Durham, NC 27705-4137

Phone

(919) 407-9415

NPI assigned

May 10, 2023

Organization subpart

No

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

Authorized official

Name

Kristina Young, LCSWNPI 1417083692

Title

Owner

Phone

(919) 407-9415

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristina Young

  • Psychiatry Physician
  • Durham, NC
  • NPI 1417083692

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1790475929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 9TH ST STE 654",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054137",
            "telephone_number": "919-407-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINA YOUNG LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-407-9415",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geanda Tilley
• Rachael Kathryn Tilley
• Frank Tillman III, PHARMD
• Ellen Tim, NP
• Lisa Hatch Timberlake, LCSWA
• Virginia Fay Tindley
• Sherwin Charng-Shiow Ting, M.D.
• Qionna Mariel Tinney, M.D.
• Sarah Tintle, PT
• Kevin Matthew Tirado Roman

• Clinical Social Worker in Durham, NC
• Providers in Durham, 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 Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.