Provider Demographics
NPI:1639571904
Name:YOUNG, EMMA (LCPC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 DEER HL N
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:ME
Mailing Address - Zip Code:04084-6367
Mailing Address - Country:US
Mailing Address - Phone:178-153-4423
Mailing Address - Fax:
Practice Address - Street 1:10 ISLAND VIEW DR APT 228
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4158
Practice Address - Country:US
Practice Address - Phone:781-534-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health