Provider Demographics
NPI:1093870396
Name:YOUNG, ELIZABETH D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:D
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DEEDY
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:228 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3822
Mailing Address - Country:US
Mailing Address - Phone:337-981-9601
Mailing Address - Fax:337-993-3481
Practice Address - Street 1:228 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3822
Practice Address - Country:US
Practice Address - Phone:337-981-9601
Practice Address - Fax:337-993-3481
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical