Healthcare Provider Details

I. General information

NPI: 1255146452
Provider Name (Legal Business Name): ANDREA YOUNG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FOREST AVE # 8
PARAMUS NJ
07652-5242
US

IV. Provider business mailing address

306 E 41ST ST
PATERSON NJ
07504-1104
US

V. Phone/Fax

Practice location:
  • Phone: 551-227-9938
  • Fax:
Mailing address:
  • Phone: 973-224-0384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00907300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: