Provider Demographics
NPI:1407105307
Name:YOUNG, AMY LYNN (MED, NCC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MED, NCC
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2434 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-6942
Mailing Address - Country:US
Mailing Address - Phone:662-844-1717
Mailing Address - Fax:662-680-6416
Practice Address - Street 1:2434 S EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6942
Practice Address - Country:US
Practice Address - Phone:662-844-1717
Practice Address - Fax:662-680-6416
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health