Provider Demographics
NPI:1821604984
Name:YOUNG, LAUREN (BCBA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GRUNEWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5597 N LYE CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-7813
Mailing Address - Country:US
Mailing Address - Phone:765-359-7700
Mailing Address - Fax:765-359-7800
Practice Address - Street 1:705 N ENGLEWOOD DR
Practice Address - Street 2:SUITE A
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-9744
Practice Address - Country:US
Practice Address - Phone:765-359-7700
Practice Address - Fax:765-359-7800
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-20-44293103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst