Provider Demographics
NPI:1528373917
Name:YOUNG, ERIC (MA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 S UNIVERSITY BLVD
Mailing Address - Street 2:304
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5446
Mailing Address - Country:US
Mailing Address - Phone:612-598-3056
Mailing Address - Fax:
Practice Address - Street 1:5201 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-2061
Practice Address - Country:US
Practice Address - Phone:303-296-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor