Provider Demographics
NPI:1043338403
Name:YOUNG, CAROL MARIE (MA, PC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:MARIE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1921
Mailing Address - Country:US
Mailing Address - Phone:419-571-0125
Mailing Address - Fax:
Practice Address - Street 1:788 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1921
Practice Address - Country:US
Practice Address - Phone:419-571-0125
Practice Address - Fax:419-756-9913
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional