Provider Demographics
NPI:1659137198
Name:YOUNG, TENE O (LGPC)
Entity Type:Individual
Prefix:
First Name:TENE
Middle Name:O
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 ALLARD CT APT 201
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4872
Mailing Address - Country:US
Mailing Address - Phone:443-813-1868
Mailing Address - Fax:
Practice Address - Street 1:10430 SHAKER DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2336
Practice Address - Country:US
Practice Address - Phone:410-921-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional