Dominique J Stevens-Young, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW015959 Issued in PA

Practice address

371 Dorothy Dr
Penn Hills, PA 15235-1831

Phone

(412) 583-7892

Fax

(412) 241-5509

NPI assigned

Jan 30, 2007

Last updated

Sep 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 7, 2021 through Oct 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dominiquestevensyoung@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenity Life Management Group

  • Community/Behavioral Health Agency
  • Penn Hills, PA
  • NPI 1801175955
  NPD (past) Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1790821379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 DOROTHY DR",
            "city": "PENN HILLS",
            "state": "PA",
            "postal_code": "152351831",
            "telephone_number": "412-583-7892",
            "fax_number": "412-241-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 DOROTHY DR",
            "city": "PENN HILLS",
            "state": "PA",
            "postal_code": "152351831",
            "telephone_number": "412-583-7892",
            "fax_number": "412-241-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS-YOUNG",
        "first_name": "DOMINIQUE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCBHO",
            "identifier": "411414",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016115230001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "PENDING",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMISE",
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley Ann Seals, M.S.
• Serenity Life Management Group
• Jacqueline Ann Shellaby, LCSW
• Janet Elizabeth Horton Spink, MA, MT-BC, LPC
• Stability Home Care Services, LLC
• Christopher Domenic Szelong, PHARMD
• Thrift Drug Inc (Rite Aid Pharmacy 10947)
• Total Renal Care Inc (Penn Hills Dialysis)
• Connie S Unetich, DC
• United Seating and Mobility, LLC (Numotion)

• Clinical Social Worker in Penn Hills, PA
• Providers in Penn Hills, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.