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General NPI Number Information
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NPI Number | 1144430828
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Entity Type | Individual
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Provider Name | NANCY YOUNG MSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 1818 DEMPSTER ST HEARTWOOD CENTER
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City | EVANSTON
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State | IL
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Zip | 60202-1003
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Country | US
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Telephone | 773-558-5355
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Fax |
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Provider Business Mailing Address
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Address Line | 2141 RIDGE AVE #2C
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City | EVANSTON
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State | IL
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Zip | 60201-2769
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Country | US
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Telephone | 773-558-5355
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801089003
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149011811
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License Number State | IL
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