Healthcare Provider Details

I. General information

NPI: 1770448995
Provider Name (Legal Business Name): LYNDA M YOUNGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4669 W CHESTER PIKE
NEWTOWN SQUARE PA
19073-2227
US

IV. Provider business mailing address

708 HEDGEROW DR
BROOMALL PA
19008-2728
US

V. Phone/Fax

Practice location:
  • Phone: 484-574-9777
  • Fax:
Mailing address:
  • Phone: 484-574-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0069461
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: