Provider Demographics
NPI:1699858548
Name:YOUNG, LEEANN (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 BURLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-5219
Mailing Address - Country:US
Mailing Address - Phone:214-467-7744
Mailing Address - Fax:214-467-7747
Practice Address - Street 1:1721 W PLANO PKWY
Practice Address - Street 2:SUITE 127
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8634
Practice Address - Country:US
Practice Address - Phone:214-467-7744
Practice Address - Fax:214-467-7747
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08888101YP2500X
TX1450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125833OtherNORTHSTAR