Provider Demographics
NPI:1821291725
Name:YOUNG, CATHERINE L (CASAC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SOUTH MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:EARLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13332
Mailing Address - Country:US
Mailing Address - Phone:315-691-3603
Mailing Address - Fax:
Practice Address - Street 1:105 LEILANIS LN
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3540
Practice Address - Country:US
Practice Address - Phone:607-337-1680
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6872101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)