Provider Demographics
NPI:1851429583
Name:YOUNG, CYNTHIA JR (MA LPC-MHSP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JR
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA LPC-MHSP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:ROE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC-MHSP
Mailing Address - Street 1:1803 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2201
Mailing Address - Country:US
Mailing Address - Phone:931-393-1300
Mailing Address - Fax:931-393-1303
Practice Address - Street 1:1803 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2201
Practice Address - Country:US
Practice Address - Phone:931-393-1300
Practice Address - Fax:931-393-1303
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health