Provider Demographics
NPI:1366655722
Name:YOUNG-RIVERS ASSOCIATES, P.S.C.
Entity Type:Organization
Organization Name:YOUNG-RIVERS ASSOCIATES, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-644-0007
Mailing Address - Street 1:4228 ASHLEYWOOD CT.
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1582
Mailing Address - Country:US
Mailing Address - Phone:502-644-0007
Mailing Address - Fax:
Practice Address - Street 1:4228 ASHLEYWOOD CT.
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1582
Practice Address - Country:US
Practice Address - Phone:502-644-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0722103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty