Provider Demographics
NPI:1841806585
Name:YOUNG, ELAINE K (LPC)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:KNAPPENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:674 PROVENCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2288
Mailing Address - Country:US
Mailing Address - Phone:256-337-4111
Mailing Address - Fax:
Practice Address - Street 1:674 PROVENCE DRIVE
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35242-2288
Practice Address - Country:US
Practice Address - Phone:256-337-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional