Provider Demographics
NPI:1659389922
Name:YOUNG, CHRISTINE LOUISE (PH D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3304
Mailing Address - Country:US
Mailing Address - Phone:845-226-1533
Mailing Address - Fax:
Practice Address - Street 1:1531 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3304
Practice Address - Country:US
Practice Address - Phone:845-226-1533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5201103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VL6071OtherMAGELLAN
NYVK2101Medicare ID - Type Unspecified