Provider Demographics
NPI:1659652543
Name:YOUNG, DENA LB (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:LB
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 ROUTE 38
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-2923
Mailing Address - Country:US
Mailing Address - Phone:609-864-2500
Mailing Address - Fax:609-518-8939
Practice Address - Street 1:1632 ROUTE 38
Practice Address - Street 2:SUITE A
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2923
Practice Address - Country:US
Practice Address - Phone:609-864-2500
Practice Address - Fax:609-518-8939
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100485500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical