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NPI Code Detail

MEDICARE: ANJANETTE LASHELL YOUNG LCSW

MEDICARE: ANJANETTE LASHELL YOUNG LCSW
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
1101YM0800XMental Health Counselor149.020.825IL

General Provider Information

NPI Number : 1669287272
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANJANETTE LASHELL YOUNG LCSW
Provider Business Mailing Address
First Line : 1019 W 110TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3741
Country : US
Telephone Number : 630-452-2301
Fax Number :
Provider Business Practice Location Address
First Line : 1019 W 110TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3741
Country : US
Telephone Number : 630-452-2301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2025
Last Update Date : 02/11/2025

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Directions to “ ANJANETTE LASHELL YOUNG LCSW” Practice Location

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