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Provider Information for 1952885436


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JENNIE R YOUNG LPC


Sex: Female

NPI: 1952885436
Last Updated: 2018-09-20
Certification Date:

Details

NameValue
NPI1952885436
Enumeration Date2018-09-20
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 739 S MARQUETTE DR
MONTGOMERY, AL 36109-3807
United States

Phone: 334-202-5015 | Fax:
 
Primary Practice Address 5510 WARES FERRY RD STE U
MONTGOMERY, AL 36117-2131
United States

Phone: 334-387-2317 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthAL3444