Healthcare Provider Details

I. General information

NPI: 1245533140
Provider Name (Legal Business Name): AYROL M YOUNG LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2010
Last Update Date: 07/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 E FAYETTE ST
BALTIMORE MD
21231-1610
US

IV. Provider business mailing address

6807 BELLONA AVE
BALTIMORE MD
21212-1221
US

V. Phone/Fax

Practice location:
  • Phone: 410-433-5255
  • Fax:
Mailing address:
  • Phone: 443-758-7228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16250
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: