MEDICARE: MS. YVETTE L YOUNG LCSW-C

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	LC303576	DC
2	1041C0700X	Clinical Social Worker	10104	MD

General Provider Information

NPI Number	:	1891133591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YVETTE L YOUNG LCSW-C

Provider Business Mailing Address
First Line	:	7800 CENTRAL AVE
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-4807
Country	:	US
Telephone Number	:	240-389-3558
Fax Number	:	866-576-0581

Provider Business Practice Location Address
First Line	:	7800 CENTRAL AVE
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-4807
Country	:	US
Telephone Number	:	240-418-7686
Fax Number	:	866-576-0581

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

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	07/31/2020

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