Provider Demographics
NPI:1821437542
Name:YOUNG, TIFFANY (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 ROLLING HILLS PL
Mailing Address - Street 2:1005
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1800
Mailing Address - Country:US
Mailing Address - Phone:214-891-5489
Mailing Address - Fax:
Practice Address - Street 1:549 W WHEATLAND RD
Practice Address - Street 2:B
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4515
Practice Address - Country:US
Practice Address - Phone:214-891-5489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-15
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68295101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health