Provider Demographics
NPI:1912479759
Name:YOUNG, SHATOYA LANEE (LPC, LCMHC)
Entity Type:Individual
Prefix:
First Name:SHATOYA
Middle Name:LANEE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 BRENTWOOD RD # 309
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-0269
Mailing Address - Country:US
Mailing Address - Phone:682-583-2188
Mailing Address - Fax:
Practice Address - Street 1:7609 TANGLEWOOD WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-9227
Practice Address - Country:US
Practice Address - Phone:469-235-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional