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General NPI Number Information
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NPI Number | 1477109411
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Entity Type | Individual
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Provider Name | DANIELLE P YOUNG LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 2901 ISLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19153-3013
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Country | US
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Telephone | 267-713-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 GEORGIAN LN
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City | BROOMALL
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State | PA
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Zip | 19008-2510
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC011554
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License Number State | PA
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