Provider Demographics
NPI:1598988420
Name:YOUNG, STEPHEN PAUL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:PAUL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:PROF
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:225 COMMERCIAL ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4613
Mailing Address - Country:US
Mailing Address - Phone:207-761-7783
Mailing Address - Fax:
Practice Address - Street 1:225 COMMERCIAL ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4613
Practice Address - Country:US
Practice Address - Phone:207-761-7783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC02155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health