Provider Demographics
NPI:1215213582
Name:YOUNGCLAUS, DANIEL PAUL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:YOUNGCLAUS
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 1:14 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-3466
Mailing Address - Country:US
Mailing Address - Phone:781-738-6773
Mailing Address - Fax:
Practice Address - Street 1:14 MAPLE LN
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-3466
Practice Address - Country:US
Practice Address - Phone:781-738-6773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health