Provider Demographics
NPI:1528594645
Name:YOUNG, EMORY BOYKINS II (LADAC II, NCACI, SAP)
Entity Type:Individual
Prefix:MR
First Name:EMORY
Middle Name:BOYKINS
Last Name:YOUNG
Suffix:II
Gender:M
Credentials:LADAC II, NCACI, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BALSAM DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-3001
Mailing Address - Country:US
Mailing Address - Phone:865-382-1037
Mailing Address - Fax:
Practice Address - Street 1:3535 NE KENILWORTH LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914
Practice Address - Country:US
Practice Address - Phone:865-382-1037
Practice Address - Fax:865-281-3274
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1198101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)