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General NPI Number Information
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NPI Number | 1134371834
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Entity Type | Individual
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Provider Name | ELEANE LATONYA YOUNG LMFT 87673
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Gender | Female
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 9327 MIDLOTHIAN TPKE STE 1D
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4965
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Country | US
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Telephone | 951-900-4414
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Fax | 951-880-0817
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Provider Business Mailing Address
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Address Line | 9327 MIDLOTHIAN TPKE STE 1D
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4965
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Country | US
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Telephone | 951-900-4414
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Fax | 951-880-0817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT87673
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001508
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License Number State | VA
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