Healthcare Provider Details

I. General information

NPI: 1124948864
Provider Name (Legal Business Name): WILLIAM DAVID YOUNG MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 FOUNTAINS BLVD NE STE 203
CEDAR RAPIDS IA
52411-6632
US

IV. Provider business mailing address

140 40TH STREET DR SE UNIT B124
CEDAR RAPIDS IA
52403-1140
US

V. Phone/Fax

Practice location:
  • Phone: 319-734-2002
  • Fax:
Mailing address:
  • Phone: 319-734-2002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number126426
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: