MEDICARE: ROBYNN YOUNG LPC

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	37PC00561800	NJ

General Provider Information

NPI Number	:	1376085910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYNN YOUNG LPC

Provider Business Mailing Address
First Line	:	68 LLEWELLYN AVE
Second Line	:	APT 1
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-5731
Country	:	US
Telephone Number	:	973-986-0707
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 LLEWELLYN AVE
Second Line	:	APT 1
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-5731
Country	:	US
Telephone Number	:	973-986-0707
Fax Number	:

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

Provider Enumeration Date	:	11/14/2016
Last Update Date	:	11/14/2016

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