Provider Demographics
NPI:1619182235
Name:YOUNG, HENRY (MA)
Entity Type:Individual
Prefix:
First Name:HENRY
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:PO BOX 2097
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02741-2097
Mailing Address - Country:US
Mailing Address - Phone:508-999-3126
Mailing Address - Fax:508-991-8579
Practice Address - Street 1:30-32R GIFFORD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744
Practice Address - Country:US
Practice Address - Phone:508-999-3126
Practice Address - Fax:508-991-8579
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor