1669584314 NPI number — BARBARA K YOUNG LCSW-C

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669584314 NPI number — BARBARA K YOUNG LCSW-C

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

YOUNG

Provider First Name:

BARBARA

Provider Middle Name:

K

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

LCSW-C

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1669584314

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/13/2015

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2336 GODDARD PKWY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SALISBURY

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21801-1126

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-334-6961

Provider Business Mailing Address Fax Number:

410-334-6362

Provider First Line Business Practice Location Address:

29520 CANVASBACK DR

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

EASTON

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21601-7124

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-822-5007

Provider Business Practice Location Address Fax Number:

410-822-5569

Provider Enumeration Date:

08/31/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 104100000X , with the licence number:  069466 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 1041C0700X , with the licence number: 15897 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 600651-848 . This is a "MAGELLAN HEALTH CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: R968 . This is a "CAREFIRST BCBS - FEDERAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 609550002 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 487954 . This is a "MHN/TRICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: LM49EA . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 522156095 . This is a "INTEGRA/CLAIMSBRIDGE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 9280287 . This is a "MHNET" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 522156095 . This is a "APS-MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 522156095 . This is a "OPTUM/UBH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 7840093 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".