Mary Beth Young, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002788 Issued in NC

Practice address

648 E Monmouth St
Winston Salem, NC 27107-3227

Phone

(336) 718-4360

Fax

(336) 718-4369

NPI assigned

Jun 12, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1902000110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 E MONMOUTH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271073227",
            "telephone_number": "336-718-4360",
            "fax_number": "336-718-4369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Grimes Blvd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272927640",
            "country_code": "US",
            "telephone_number": "336-224-6071",
            "fax_number": "336-224-6393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Nathan Young, M.D.
• Jill Trawick Young, FNP
• Kathryn Young, AUD
• Kelly Young
• Lari Calton Young, MD
• Patrick Joshua Young, DO
• William Watson Young, MD
• Courtney Youngs, CRNA
• Caleb Younts, RPH
• Your Therapy Specialists, LLC

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, 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 Jan 25, 2024; 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.