Provider Demographics
NPI:1396412706
Name:YOUNG, DENENE (LPC)
Entity Type:Individual
Prefix:
First Name:DENENE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DUNLAP CT
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9501
Mailing Address - Country:US
Mailing Address - Phone:217-352-0200
Mailing Address - Fax:217-607-1139
Practice Address - Street 1:7 DUNLAP CT
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9501
Practice Address - Country:US
Practice Address - Phone:217-352-0200
Practice Address - Fax:217-607-1139
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional