Healthcare Provider Details

I. General information

NPI: 1356204168
Provider Name (Legal Business Name): MR. CLIFTON C YOUNG II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 NW 49TH ST
LINCOLN NE
68524
US

IV. Provider business mailing address

4000 NW 49TH ST
LINCOLN NE
68524
US

V. Phone/Fax

Practice location:
  • Phone: 402-225-6336
  • Fax: 402-225-6336
Mailing address:
  • Phone: 402-225-6336
  • Fax: 402-225-6336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberH14283854
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: