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NPI Code Detail

MEDICARE: REBECCA-JO SALUNEK YOUNG LCSW, ADC

MEDICARE: REBECCA-JO SALUNEK YOUNG LCSW, ADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904003538VA
2101YA0400XAddiction (Substance Use Disorder) Counselor06000911AVA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1O83896OTHERVAOPTIMA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3285589OTHERVAANTHEM
4004945395OTHERVAVA PREMIER

General Provider Information

NPI Number : 1619052958
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA-JO SALUNEK YOUNG LCSW, ADC
Provider Business Mailing Address
First Line : PO BOX 8794
Second Line :
City : NORFOLK
State : VA
Zip : 23503-0794
Country : US
Telephone Number : 757-705-8620
Fax Number :
Provider Business Practice Location Address
First Line : 225 W OLNEY RD
Second Line :
City : NORFOLK
State : VA
Zip : 23510-1534
Country : US
Telephone Number : 757-823-1600
Fax Number : 757-823-1601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 05/08/2013

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