Healthcare Provider Details

I. General information

NPI: 1861948606
Provider Name (Legal Business Name): ALEXANDER YOUNG PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 01/26/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 M ST SW APT 2726
WASHINGTON DC
20024-3733
US

IV. Provider business mailing address

465 M ST SW APT 2726
WASHINGTON DC
20024-3733
US

V. Phone/Fax

Practice location:
  • Phone: 210-887-4301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number024647
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number38756
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number38756
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: