Provider Demographics
NPI:1689893752
Name:YOUNG, SUSAN NELSON (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:NELSON
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 CAUGHEY RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2158
Mailing Address - Country:US
Mailing Address - Phone:814-459-3272
Mailing Address - Fax:814-459-3714
Practice Address - Street 1:1353 W 6TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-2503
Practice Address - Country:US
Practice Address - Phone:814-459-3272
Practice Address - Fax:814-459-3714
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003765101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional