Provider Demographics
NPI:1275663627
Name:YOUNG, DENISE EDWARDS (MSW, LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:EDWARDS
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MSW, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E 14TH ST
Mailing Address - Street 2:#1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2709
Mailing Address - Country:US
Mailing Address - Phone:212-674-4486
Mailing Address - Fax:
Practice Address - Street 1:817 BROADWAY
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4709
Practice Address - Country:US
Practice Address - Phone:917-847-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0465511041C0700X
FLSW 67271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical