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NPI Code Detail

MEDICARE: ERIC C. YOUNG LISW-S

MEDICARE: ERIC C. YOUNG LISW-S
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 WorkerI 0010310OH

General Provider Information

NPI Number : 1558584953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC C. YOUNG LISW-S
Provider Business Mailing Address
First Line : 6605 W CENTRAL AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43617-1000
Country : US
Telephone Number : 419-841-7701
Fax Number :
Provider Business Practice Location Address
First Line : 424 W WOODRUFF AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43604-5027
Country : US
Telephone Number : 419-841-7701
Fax Number : 419-255-5623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 02/24/2016

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