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General NPI Number Information
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NPI Number | 1720156292
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Entity Type | Individual
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Provider Name | MICHELE YOUNG LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 6186 BIRKEWOOD RD
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City | HUNTINGTON
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State | WV
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Zip | 25705-2202
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Country | US
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Telephone | 304-736-6264
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Fax | 304-736-4852
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Provider Business Mailing Address
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Address Line | 6186 BIRKEWOOD RD
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City | HUNTINGTON
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State | WV
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Zip | 25705-2202
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Country | US
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Telephone | 304-736-6264
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Fax | 304-736-4852
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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 | DP00452143
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License Number State | WV
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