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General NPI Number Information
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NPI Number | 1518495399
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Entity Type | Organization
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Legal Business Name | ERIK YOUNG COUNSELING LLC
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Dates
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Enumeration Date | 05/24/2017
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Last Update Date | 05/24/2017
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Provider Practice Location Address
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Address Line | 101 MANOR AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2601
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Country | US
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Telephone | 484-693-0582
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Fax | 484-631-0502
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Provider Business Mailing Address
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Address Line | 126 MEADOWLAKE DR
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2145
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Country | US
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Telephone | 610-207-1294
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIK YOUNG
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Credential | M.ED., LPC
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Telephone | 484-693-0582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PC005853
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License Number State | PA
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