Provider Demographics
NPI:1003861683
Name:YOUNG, EAN VINCENZO (LPC, LMFT, CEAP, NCC)
Entity Type:Individual
Prefix:
First Name:EAN
Middle Name:VINCENZO
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LPC, LMFT, CEAP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 OLIVE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-5655
Mailing Address - Country:US
Mailing Address - Phone:337-501-1255
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERSON ST
Practice Address - Street 2:SUITE 902
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6942
Practice Address - Country:US
Practice Address - Phone:337-993-0000
Practice Address - Fax:337-354-2410
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2817101YP2500X
LA236106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist