MEDICARE: HAROLD 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
1	1041C0700X	Clinical Social Worker	LCS11789	CA

General Provider Information

NPI Number	:	1851654495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD YOUNG LCSW

Provider Business Mailing Address
First Line	:	342 ANZIO WAY
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-4851
Country	:	US
Telephone Number	:	818-917-7732
Fax Number	:

Provider Business Practice Location Address
First Line	:	342 ANZIO WAY
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-4851
Country	:	US
Telephone Number	:	818-917-7732
Fax Number	:

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

Provider Enumeration Date	:	06/19/2012
Last Update Date	:	07/21/2022

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