Provider Demographics
NPI:1568518926
Name:YOUNG, AMY R (MS, MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:R
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, MSW, LCSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:R
Other - Last Name:KUHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MSW, LCSW
Mailing Address - Street 1:18121 W CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5641
Mailing Address - Country:US
Mailing Address - Phone:704-237-0475
Mailing Address - Fax:
Practice Address - Street 1:18121 W CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5641
Practice Address - Country:US
Practice Address - Phone:704-237-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0039161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14488OtherBCBS
NC14488OtherBCBS