Healthcare Provider Details

I. General information

NPI: 1801103239
Provider Name (Legal Business Name): SHAWN WARREN YOUNG LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31G CENTRAL ST
HILLSBOROUGH NH
03244-4352
US

IV. Provider business mailing address

31G CENTRAL ST
HILLSBOROUGH NH
03244-4352
US

V. Phone/Fax

Practice location:
  • Phone: 603-738-3385
  • Fax:
Mailing address:
  • Phone: 603-738-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1737
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1737
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: