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General NPI Number Information
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NPI Number | 1033582184
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Entity Type | Organization
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Legal Business Name | THOMAS D. YOUNG, LMHC
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 1432 MARTIN LUTHER KING ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33704-3302
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Country | US
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Telephone | 443-995-5898
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Fax | 727-821-6914
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Provider Business Mailing Address
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Address Line | 1432 MARTIN LUTHER KING ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33704-3302
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Country | US
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Telephone | 443-995-5898
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Fax | 727-821-6914
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. THOMAS DANIEL YOUNG
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Credential | MS
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Telephone | 443-995-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH9706
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License Number State | FL
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