Individual provider Active NPI

Paul Bennett Young, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1841473949
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS19632 Issued in CA
Practice address
11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Phone
(310) 966-6667
NPI assigned
Dec 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 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 LCS19632 CA Primary

Addresses

Primary practice location

11080 W Olympic Blvd
Los Angeles, CA 90064-1937

Mailing address

11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Phone (310) 966-6667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080418000533 CA Practitioner - Clinical Social Worker 4688752488 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS19632CAMDClinical Social Worker
19632CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 13, 2013 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Jul 1, 2025 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 13, 2013 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Sep 1, 2023 Accepting new patients

Locations

11080 W Olympic Blvd
Los Angeles, CA 90064
Phone (310) 966-6500

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

11303 W Washington Blvd
#200
Los Angeles, CA 90066
Phone (310) 482-3200

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1841473949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11080 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641937",
            "telephone_number": "310-966-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641937",
            "telephone_number": "310-966-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PAUL",
        "middle_name": "BENNETT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS19632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.