Healthcare Provider Details

I. General information

NPI: 1619890050
Provider Name (Legal Business Name): JOLIE AREEYA YOUNG LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 KINGS MOUNTAIN BLVD
KINGS MOUNTAIN NC
28086-9121
US

IV. Provider business mailing address

200 E 2ND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 704-476-8366
  • Fax:
Mailing address:
  • Phone: 704-874-1904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP024333
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: