Provider Demographics
NPI:1013232552
Name:YOUNG, HENRY PAUL
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:PAUL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:WURTSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12790-0764
Mailing Address - Country:US
Mailing Address - Phone:845-888-4390
Mailing Address - Fax:
Practice Address - Street 1:34 N PLANK RD
Practice Address - Street 2:STE 1
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2138
Practice Address - Country:US
Practice Address - Phone:845-888-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031292-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical