Provider Demographics
NPI:1619956711
Name:YOUNG, DAVID WAYNE (LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 ACT CIR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9512
Mailing Address - Country:US
Mailing Address - Phone:319-337-6483
Mailing Address - Fax:319-337-4208
Practice Address - Street 1:2101 ACT CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9512
Practice Address - Country:US
Practice Address - Phone:319-337-6483
Practice Address - Fax:319-337-4208
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist