Provider Demographics
NPI:1417383936
Name:YOUNG, NICOLE L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:L
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 1:13201 NORTHWEST FWY STE 824
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6008
Mailing Address - Country:US
Mailing Address - Phone:713-444-5954
Mailing Address - Fax:
Practice Address - Street 1:13201 NORTHWEST FWY STE 824
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6008
Practice Address - Country:US
Practice Address - Phone:713-444-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67197101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional