Provider Demographics
NPI:1821149378
Name:YOUNG, THOMAS D (LCPC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:D
Last Name:YOUNG
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 SYPE DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-3306
Mailing Address - Country:US
Mailing Address - Phone:443-995-5898
Mailing Address - Fax:727-255-6200
Practice Address - Street 1:312 SYPE DR
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-3306
Practice Address - Country:US
Practice Address - Phone:443-995-5898
Practice Address - Fax:727-255-6200
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP2500X
MDLC1479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional