Provider Demographics
NPI:1821149378
Name:YOUNG, THOMAS D (LCPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:D
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6935 WISCONSIN AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6109
Mailing Address - Country:US
Mailing Address - Phone:301-907-3378
Mailing Address - Fax:
Practice Address - Street 1:6935 WISCONSIN AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6109
Practice Address - Country:US
Practice Address - Phone:301-907-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health