Provider Demographics
NPI:1134934359
Name:YOUNG, SUZETTE (CSC-AD, LGPC)
Entity type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CSC-AD, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 TURF RUN CIR
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5321
Mailing Address - Country:US
Mailing Address - Phone:443-599-3646
Mailing Address - Fax:
Practice Address - Street 1:8840 STANFORD BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5827
Practice Address - Country:US
Practice Address - Phone:443-379-4558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC2106101YA0400X
MDLGP15488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)