MEDICARE: HENRY YOUNG MA

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	CSW04406	RI

General Provider Information

NPI Number	:	1619182235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY YOUNG MA

Provider Business Mailing Address
First Line	:	148 ATWOOD AVE #1010, CRANSTON RI 02920
Second Line	:
City	:	ROCHESTER
State	:	MA
Zip	:	02770
Country	:	US
Telephone Number	:	508-971-1904
Fax Number	:

Provider Business Practice Location Address
First Line	:	148 ATWOOD AVE #1010, CRANSTON RI 02920
Second Line	:
City	:	ROCHESTER
State	:	MA
Zip	:	02770
Country	:	US
Telephone Number	:	508-971-1904
Fax Number	:

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	03/09/2026

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Directions to “ HENRY YOUNG MA” Practice Location

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