MEDICARE: BARNETTA J YOUNG MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC0003985	GA

General Provider Information

NPI Number	:	1164692919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARNETTA J YOUNG MS

Provider Business Mailing Address
First Line	:	PO BOX 161255
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30321-1255
Country	:	US
Telephone Number	:	678-478-0387
Fax Number	:

Provider Business Practice Location Address
First Line	:	957 MAIN ST STE A-379
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3060
Country	:	US
Telephone Number	:	404-766-6017
Fax Number	:	770-987-7327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	12/11/2025

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