Provider Demographics
NPI:1720476443
Name:YOUNG, CATHLEEN (MA, LMHC, LPC, PC)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, LMHC, LPC, PC
Other - Prefix:
Other - First Name:CATHLEEN
Other - Middle Name:
Other - Last Name:MALLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:297 E SHORE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ARIEL
Mailing Address - State:PA
Mailing Address - Zip Code:18436-4701
Mailing Address - Country:US
Mailing Address - Phone:518-572-4045
Mailing Address - Fax:
Practice Address - Street 1:297 E SHORE DR
Practice Address - Street 2:
Practice Address - City:LAKE ARIEL
Practice Address - State:PA
Practice Address - Zip Code:18436-4701
Practice Address - Country:US
Practice Address - Phone:520-314-6519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional