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General NPI Number Information
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NPI Number | 1366682866
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Entity Type | Individual
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Provider Name | CHERYL RENA YOUNG M.A., LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 10116 36TH AVE CT SW SUITE 2
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City | LAKEWOOD
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State | WA
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Zip | 98499
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Country | US
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Telephone | 253-212-1754
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Fax | 253-212-1832
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Provider Business Mailing Address
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Address Line | 10116 36TH AVE CT SW SUITE 2
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City | LAKEWOOD
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State | WA
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Zip | 98499
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Country | US
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Telephone | 253-212-1754
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Fax | 253-212-1832
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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 | LH00004498
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License Number State | WA
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