Individual provider Active NPI

Amy L Young, LCSW

  • Clinical Social Worker
  • Westport, CT
National Provider Identifier
1962882563
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004325 Issued in CT
Practice address
47 Long Lots Rd
Westport, CT 06880-3828
Phone
(203) 341-4512
Fax
(203) 227-9526
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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 004325 CT Primary

Addresses

Primary practice location

47 Long Lots Rd
Westport, CT 06880-3828

Mailing address

47 Long Lots Rd
Westport, CT 06880-3828
Phone (203) 341-4512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160125001838 CT Practitioner - Clinical Social Worker 9335459585 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Young LCSW - PLLC Clinical Current Accepting new patients
Neighborhood Health, Inc. CurrentSince Dec 15, 2015 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

179 Post Rd W
Fl 2
Westport, CT 06880
Phone (201) 248-7361

47 Long Lots Rd
Westport, CT 06880
Phone (203) 221-8801

Organizations & group practices 2

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1962882563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 LONG LOTS RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803828",
            "telephone_number": "203-341-4512",
            "fax_number": "203-227-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 LONG LOTS RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803828",
            "telephone_number": "203-341-4512",
            "fax_number": "203-227-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.