MEDICARE: MRS. LORIE ANNE YOUNGER

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	LCSW122301	CA
2	1041C0700X	Clinical Social Worker	LICSW1121435	MA

General Provider Information

NPI Number	:	1366978058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORIE ANNE YOUNGER

Provider Business Mailing Address
First Line	:	163 HIGHLAND AVE # 1078
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3025
Country	:	US
Telephone Number	:	310-507-9901
Fax Number	:

Provider Business Practice Location Address
First Line	:	163 HIGHLAND AVE # 1078
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3025
Country	:	US
Telephone Number	:	310-507-9901
Fax Number	:

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

Provider Enumeration Date	:	05/02/2017
Last Update Date	:	12/11/2025

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