Provider Demographics
NPI:1639510928
Name:YOUNG, MARLEENA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARLEENA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10221 FALLING LEAF DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8139
Mailing Address - Country:US
Mailing Address - Phone:704-345-8995
Mailing Address - Fax:
Practice Address - Street 1:10221 FALLING LEAF DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8139
Practice Address - Country:US
Practice Address - Phone:704-345-8995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0078361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical