Theodore Young Jr., LMSW, C-ASWCM, MPA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7949 Issued in TN

Practice address

6098 Debra Rd
Suite 5200
Chattanooga, TN 37411-5702

Phone

(423) 893-6500

NPI assigned

Dec 15, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1871862193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 WYNDSOR DR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373432210",
            "telephone_number": "423-710-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6098 DEBRA RD",
            "address_2": "SUITE 5200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374115702",
            "telephone_number": "423-893-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "THEODORE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMSW, C-ASWCM, MPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-15",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Steven Young, CRNA
• Michael Duane Young, FNP-C
• Milou Steel Young, NP-C
• Shania Naomi-Storm Young
• Tammy Young, LPN
• Timothy Blake Young, PHARM.D., MBA
• Tye B. Young, D.O.
• Laura Bond Youngblood, MD
• Zachary Cole Youngblood, DMD
• Anna Downer Youngs

• Clinical Social Worker in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.