| Tina Young Lcsw Pllc | |
|
817 Broad St Durham NC 27705-4137 | |
| (919) 407-9415 | |
| Not Available |
| Full Name | Tina Young Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 817 Broad St, Durham, North Carolina |
| Authorized Official Name and Position | Kristina Young (OWNER) |
| Authorized Official Contact | 9194079415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Young Lcsw Pllc 732 9th St Ste 654 Durham NC 27705-4803 Ph: () - | Tina Young Lcsw Pllc 817 Broad St Durham NC 27705-4137 Ph: (919) 407-9415 |
| NPI Number | 1790475929 |
|---|---|
| Provider Enumeration Date | 05/10/2023 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Medicare PECOS PAC ID | 6709249477 |
|---|---|
| Medicare Enrollment ID | O20230828003972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790475929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristina L Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417083692 PECOS PAC ID: 4981622529 Enrollment ID: I20051102000966 |
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