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General NPI Number Information
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NPI Number | 1467663633
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Entity Type | Individual
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Provider Name | MARTIN YOUNG MSW,LICSW
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Gender | Male
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Dates
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Enumeration Date | 05/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 ERDMAN WAY
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City | LEOMINSTER
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State | MA
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Zip | 01453-1804
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Country | US
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Telephone | 978-466-8341
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Fax |
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Provider Business Mailing Address
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Address Line | 101 EGERTON RD
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City | ARLINGTON
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State | MA
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Zip | 02474-8520
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Country | US
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Telephone | 781-910-0391
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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 | 106592
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License Number State | MA
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