MEDICARE: JOCELYN R YOUNG LCSW

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
1	1041C0700X	Clinical Social Worker	SW10180	FL

General Provider Information

NPI Number	:	1174809735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN R YOUNG LCSW

Provider Business Mailing Address
First Line	:	1171 NW 15TH AVE APT 207
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33486-2057
Country	:	US
Telephone Number	:	561-674-3637
Fax Number	:

Provider Business Practice Location Address
First Line	:	5549 PACIFIC BLVD APT 4012
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433
Country	:	US
Telephone Number	:	561-674-3637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	11/04/2019

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