Provider Demographics
NPI:1396585311
Name:YOUNG, ERIN MICHELLE (LMSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELLE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MICHELLE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 NE SILKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2329
Mailing Address - Country:US
Mailing Address - Phone:515-988-0745
Mailing Address - Fax:
Practice Address - Street 1:9105 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-4807
Practice Address - Country:US
Practice Address - Phone:515-984-0225
Practice Address - Fax:515-984-0226
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1242741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical