Provider Demographics
NPI:1245970268
Name:YOUNG, DARNELL LAMONT (LPC)
Entity type:Individual
Prefix:MR
First Name:DARNELL
Middle Name:LAMONT
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 BIFFLE DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-4205
Mailing Address - Country:US
Mailing Address - Phone:312-925-7441
Mailing Address - Fax:
Practice Address - Street 1:1915 BIFFLE DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-4205
Practice Address - Country:US
Practice Address - Phone:312-915-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health