Provider Demographics
NPI:1215088653
Name:YOUNGS, PATRICIA MARIE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARIE
Last Name:YOUNGS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SPRAGUE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-2112
Mailing Address - Country:US
Mailing Address - Phone:401-219-9400
Mailing Address - Fax:401-267-0105
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:A 102
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:491-219-9400
Practice Address - Fax:401-267-0010
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00248101YM0800X
FLMH6685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI29887-0OtherBLUE CROSS BLUE SHIELD
RI412855OtherBLUE CHIP