Provider Demographics
NPI:1437270832
Name:YOUNG, JOYCEANN LYNOM (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOYCEANN
Middle Name:LYNOM
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30484
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38130-0484
Mailing Address - Country:US
Mailing Address - Phone:901-396-2273
Mailing Address - Fax:901-785-0297
Practice Address - Street 1:1444 E SHELBY DR
Practice Address - Street 2:429
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7260
Practice Address - Country:US
Practice Address - Phone:901-396-2273
Practice Address - Fax:901-785-0297
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN563101YM0800X, 103T00000X, 106H00000X
MS563101YM0800X, 103T00000X, 106H00000X
TN202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4091466OtherBLUECROSS AND BLUESHIELD
TN028717OtherMHN
TN41427934601OtherUNITED BEHAVORIAL HLTH
TN194822OtherCOMSYCH
TN252669OtherMAGELLAN
TN0782399OtherMAGELLAN