Healthcare Provider Details

I. General information

NPI: 1053229096
Provider Name (Legal Business Name): DONALD J. YOUNG ED. S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 EBENEZER RD
CINCINNATI OH
45248-4099
US

IV. Provider business mailing address

3200 EBENEZER RD
CINCINNATI OH
45248-4099
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-2300
  • Fax:
Mailing address:
  • Phone: 513-922-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01393
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: