Provider Demographics
NPI:1558677948
Name:YOUNG, CARRIE PATRICIA (LMSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:PATRICIA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2657 BURNINGBUSH DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-4527
Mailing Address - Country:US
Mailing Address - Phone:586-899-6114
Mailing Address - Fax:
Practice Address - Street 1:2657 BURNINGBUSH DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-4527
Practice Address - Country:US
Practice Address - Phone:586-899-6114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010880081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical