Active NPI
Shahtavia Young, LSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1992420525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.028587
- Practice address
- 405 W Superior St Ste 427
Chicago, IL 60654-8501 - Phone
- (773) 897-3197
- NPI assigned
- Oct 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.028587 | IL | Primary |
| Social Worker | 104100000X | 150.106617 | IL |
Addresses
Primary practice location
405 W Superior St Ste 427
Chicago, IL 60654-8501
Mailing address
405 W Superior St Ste 427
Chicago, IL 60654-8501
Phone (773) 897-3197
Other names 1
- Shah'Tavia Young
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16000 Wabash Ave
South Holland, IL 60473-1464
Phone (708) 339-0600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.106617 | IL | MD | Social Worker |
| 149.028587 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Clinical | Current | Accepting new patients |
Locations
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
16000 Wabash Ave
South Holland, IL 60473
Phone (219) 769-9009
Organizations & group practices 1
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": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751587200000",
"number": "1992420525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 W SUPERIOR ST STE 427",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606548501",
"telephone_number": "773-897-3197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W SUPERIOR ST STE 427",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606548501",
"telephone_number": "773-897-3197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "SHAHTAVIA",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-06",
"last_updated": "2025-07-04",
"certification_date": "2025-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.028587",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.106617",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHAH'TAVIA",
"last_name": "YOUNG",
"credential": "LSW",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.