Healthcare Provider Details

I. General information

NPI: 1770036261
Provider Name (Legal Business Name): HEATHER CALDWELL YOUNG PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13635 N 28TH ST
PHOENIX AZ
85032-5912
US

IV. Provider business mailing address

13635 N 28TH ST
PHOENIX AZ
85032-5912
US

V. Phone/Fax

Practice location:
  • Phone: 602-777-3585
  • Fax: 844-733-7326
Mailing address:
  • Phone: 602-777-3585
  • Fax: 844-733-7326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number005294
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: