MEDICARE: MR. TIMOTHY YOUNG LMSW

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	104100000X	Social Worker	69056	TX

General Provider Information

NPI Number	:	1649913062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY YOUNG LMSW

Provider Business Mailing Address
First Line	:	7430 LOUIS PASTEUR DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4507
Country	:	US
Telephone Number	:	210-865-0219
Fax Number	:

Provider Business Practice Location Address
First Line	:	7430 LOUIS PASTEUR DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4507
Country	:	US
Telephone Number	:	210-259-1290
Fax Number	:

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

Provider Enumeration Date	:	04/14/2022
Last Update Date	:	04/14/2022

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