Provider Demographics
NPI:1376974659
Name:YOUNG, ANGELA (LCSWA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S BRAGG ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-2048
Mailing Address - Country:US
Mailing Address - Phone:828-659-3418
Mailing Address - Fax:
Practice Address - Street 1:108 S BRAGG ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-2048
Practice Address - Country:US
Practice Address - Phone:801-755-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor