Healthcare Provider Details

I. General information

NPI: 1811389448
Provider Name (Legal Business Name): TROY MARIE YOUNG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 SIERRA BONITA CT
MAPLETON UT
84664-5041
US

IV. Provider business mailing address

148 SIERRA BONITA CT
MAPLETON UT
84664-5041
US

V. Phone/Fax

Practice location:
  • Phone: 385-685-0407
  • Fax:
Mailing address:
  • Phone: 385-685-0407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9802973-3501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: