Provider Demographics
NPI:1174818371
Name:YOUNG, SHAREE L (LMSW)
Entity Type:Individual
Prefix:
First Name:SHAREE
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 W SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-3347
Mailing Address - Country:US
Mailing Address - Phone:501-812-2814
Mailing Address - Fax:
Practice Address - Street 1:3000 WEST SCENIC DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118
Practice Address - Country:US
Practice Address - Phone:501-812-2814
Practice Address - Fax:501-812-2733
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6314-M101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor