Provider Demographics
NPI:1811725773
Name:YOUNG, ALEXIA (MMFT, LMFT-A)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MMFT, LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LONE WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-6423
Mailing Address - Country:US
Mailing Address - Phone:864-483-9485
Mailing Address - Fax:
Practice Address - Street 1:716 E FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-3688
Practice Address - Country:US
Practice Address - Phone:864-483-9485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9103106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist