Healthcare Provider Details

I. General information

NPI: 1205761814
Provider Name (Legal Business Name): CHRISTINA YOUNG LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 W 72ND ST FL 3
NEW YORK NY
10023-3204
US

IV. Provider business mailing address

PO BOX 362
TAPPAN NY
10983-0362
US

V. Phone/Fax

Practice location:
  • Phone: 212-777-7779
  • Fax:
Mailing address:
  • Phone: 646-285-4565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number017418-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: