Provider Demographics
NPI:1457034233
Name:YOUNG, LEAH HABERER
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:HABERER
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9410 RAINTREE RD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1946
Mailing Address - Country:US
Mailing Address - Phone:808-421-8119
Mailing Address - Fax:
Practice Address - Street 1:9410 RAINTREE RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1946
Practice Address - Country:US
Practice Address - Phone:808-421-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker