MEDICARE: MR. WILLIAM ARTHUR YOUNG III L.P.C.

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	101YM0800X	Mental Health Counselor	0701001463	VA

General Provider Information

NPI Number	:	1447378062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM ARTHUR YOUNG III L.P.C.

Provider Business Mailing Address
First Line	:	11870 SUNRISE VALLEY DR
Second Line	:	SUITE 200
City	:	RESTON
State	:	VA
Zip	:	20191-3304
Country	:	US
Telephone Number	:	703-391-7380
Fax Number	:	703-391-7381

Provider Business Practice Location Address
First Line	:	11870 SUNRISE VALLEY DR
Second Line	:	SUITE 200
City	:	RESTON
State	:	VA
Zip	:	20191-3304
Country	:	US
Telephone Number	:	703-391-7380
Fax Number	:	703-391-7381

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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