Healthcare Provider Details

I. General information

NPI: 1770004533
Provider Name (Legal Business Name): PATRICK YOUNG LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 01/18/2026
Certification Date: 01/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MAIN ST STE 103
GEORGETOWN KY
40324-1780
US

IV. Provider business mailing address

8134 NEW LA GRANGE RD STE 100
LOUISVILLE KY
40222-4677
US

V. Phone/Fax

Practice location:
  • Phone: 502-709-9050
  • Fax:
Mailing address:
  • Phone: 502-472-7293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number165707
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number165707
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: