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NPI Code Detail

MEDICARE: TIFFANY L YOUNG LPC

MEDICARE: TIFFANY L 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
1101YP2500XProfessional CounselorPC007295PA

General Provider Information

NPI Number : 1447657424
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY L YOUNG LPC
Provider Business Mailing Address
First Line : 2742 KEEBLER CT
Second Line :
City : WILLOW GROVE
State : PA
Zip : 19090-1147
Country : US
Telephone Number : 215-570-0092
Fax Number :
Provider Business Practice Location Address
First Line : 7301 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-1726
Country : US
Telephone Number : 267-297-5170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2014
Last Update Date : 12/20/2024

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