Healthcare Provider Details

I. General information

NPI: 1962646802
Provider Name (Legal Business Name): VERLEE YOUNG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W LAUREL AVE
FOLEY AL
36535-1919
US

IV. Provider business mailing address

240 W LAUREL AVE
FOLEY AL
36535-1919
US

V. Phone/Fax

Practice location:
  • Phone: 251-943-5885
  • Fax:
Mailing address:
  • Phone: 251-943-5885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1621-C
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number0571-1621C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: