Healthcare Provider Details

I. General information

NPI: 1528335502
Provider Name (Legal Business Name): JENNIFER LYNN YOUNG LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 POST RD STE 103
WARWICK RI
02886-2217
US

IV. Provider business mailing address

195 MANOLLA AVE STE 402
WARWICK RI
02888-1914
US

V. Phone/Fax

Practice location:
  • Phone: 401-952-2859
  • Fax: 401-952-2859
Mailing address:
  • Phone: 401-952-2859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: