Provider Demographics
NPI:1013256429
Name:YOUNG, JAMES ALVA JR (MA, CACP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALVA
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:MA, CACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-3234
Mailing Address - Country:US
Mailing Address - Phone:864-582-7588
Mailing Address - Fax:864-582-0431
Practice Address - Street 1:187 W BROAD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3234
Practice Address - Country:US
Practice Address - Phone:864-582-7588
Practice Address - Fax:864-582-0431
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC00000OtherMA, CACP