Healthcare Provider Details

I. General information

NPI: 1881228971
Provider Name (Legal Business Name): BARBARA ANN YOUNG MSW, LCSW, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 FORD AVENUE
MILLLTOWN NJ
08850-1532
US

IV. Provider business mailing address

32 FORD AVENUE
MILLLTOWN NJ
08850-1532
US

V. Phone/Fax

Practice location:
  • Phone: 732-777-1940
  • Fax: 732-777-1889
Mailing address:
  • Phone: 732-777-1940
  • Fax: 732-777-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number445C05171100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number37LC00065800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: