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NPI Code Detail

MEDICARE: RITA J YOUNGER LICSW

MEDICARE: RITA J YOUNGER LICSW
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 Worker351MN

General Provider Information

NPI Number : 1114022258
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA J YOUNGER LICSW
Provider Business Mailing Address
First Line : 2550 UNIVERSITY AVE W
Second Line : STE 435 S
City : SAINT PAUL
State : MN
Zip : 55114-1052
Country : US
Telephone Number : 651-647-1900
Fax Number :
Provider Business Practice Location Address
First Line : 5821 CEDAR LAKE RD S
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-1487
Country : US
Telephone Number : 651-647-1900
Fax Number : 651-647-1861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 04/13/2021

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Directions to “ RITA J YOUNGER LICSW” Practice Location

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