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General NPI Number Information
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NPI Number | 1144219650
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Entity Type | Individual
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Provider Name | JAMES HENRY YOUNG JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 5435 PROSPERITY CHURCH RD SUITE 2200
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City | CHARLOTTE
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State | NC
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Zip | 28269-2331
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Country | US
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Telephone | 704-863-9830
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Fax | 704-863-9831
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Provider Business Mailing Address
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Address Line | PO BOX 602120
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City | CHARLOTTE
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State | NC
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Zip | 28260-2120
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Country | US
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Telephone | 704-863-9830
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Fax | 704-863-9831
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 996
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License Number State | NC
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