Provider Demographics
NPI:1881688240
Name:YOUNG, RENEE E (MS LMFT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:E
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4923
Mailing Address - Country:US
Mailing Address - Phone:252-975-2027
Mailing Address - Fax:252-975-3483
Practice Address - Street 1:105 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4923
Practice Address - Country:US
Practice Address - Phone:252-975-2027
Practice Address - Fax:252-975-3483
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2050823OtherCIGNA
323663OtherMHN
1353VOtherBCBS
NC6105008Medicaid