Healthcare Provider Details

I. General information

NPI: 1518686724
Provider Name (Legal Business Name): STEFAN ALEXANDER YOUNG-SHERFEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 E. MAIN STREET STE 1604-ITB
RICHMOND VA
23219
US

IV. Provider business mailing address

919 E. MAIN STREET STE 1604-ITB
RICHMOND VA
23219
US

V. Phone/Fax

Practice location:
  • Phone: 804-800-7294
  • Fax:
Mailing address:
  • Phone: 804-800-7294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC200002275
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: