Active NPI
Rosalie NA Young, LCSW
- Clinical Social Worker
- Bethel, CT
National Provider Identifier
1790709723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 001548
- Practice address
- 97 Chestnut St Apt D
Bethel, CT 06801-2663 - Phone
- (203) 792-6937
- Fax
- (203) 792-6937
- NPI assigned
- Jul 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 001548 | CT | Primary |
Addresses
Primary practice location
97 Chestnut St Apt D
Bethel, CT 06801-2663
Mailing address
97 Chestnut St Apt D
Bethel, CT 06801-2663
Phone (203) 792-6937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 091803 | Other | CT | VALUE OPTIONS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001548 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790709723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 CHESTNUT ST APT D",
"city": "BETHEL",
"state": "CT",
"postal_code": "068012663",
"telephone_number": "203-792-6937",
"fax_number": "203-792-6937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 CHESTNUT ST APT D",
"city": "BETHEL",
"state": "CT",
"postal_code": "068012663",
"telephone_number": "203-792-6937",
"fax_number": "203-792-6937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "ROSALIE",
"middle_name": "NA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "001548",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "091803",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.