Provider Demographics
NPI:1700846441
Name:YOUNG, LARRY D (LIC PSYCHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:D
Last Name:YOUNG
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Gender:M
Credentials:LIC PSYCHOLOGIST
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:STE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1208 EASTCHESTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3170
Practice Address - Country:US
Practice Address - Phone:336-802-2536
Practice Address - Fax:336-802-2534
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2014-02-18
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Provider Licenses
StateLicense IDTaxonomies
NC764103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60525OtherMEDCOST
NC2063642OtherCIGNA BEHAVIORAL HEALTH
NC4827OtherBCBS OF NC
NC100586OtherUNITED BEHAVIORAL HEALTH
NC6000734Medicaid
NC6000734Medicaid
NC2063642OtherCIGNA BEHAVIORAL HEALTH