Provider Demographics
NPI:1013229459
Name:YOUNG, ROLLAND L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROLLAND
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11402 ASHCROFT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-2406
Mailing Address - Country:US
Mailing Address - Phone:713-598-0110
Mailing Address - Fax:
Practice Address - Street 1:1712 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-1967
Practice Address - Country:US
Practice Address - Phone:713-598-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical