Provider Demographics
NPI:1346542750
Name:YOUNGS, HEATHER JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JEAN
Last Name:YOUNGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25440 INDIAN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CALCIUM
Mailing Address - State:NY
Mailing Address - Zip Code:13616-2213
Mailing Address - Country:US
Mailing Address - Phone:315-629-4234
Mailing Address - Fax:315-629-4571
Practice Address - Street 1:25440 INDIAN RIVER DR
Practice Address - Street 2:
Practice Address - City:CALCIUM
Practice Address - State:NY
Practice Address - Zip Code:13616-2213
Practice Address - Country:US
Practice Address - Phone:315-629-4234
Practice Address - Fax:315-629-4571
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0776951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical