Provider Demographics
NPI:1386919629
Name:YOUNG, WILLIAM W (LPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316S ASYLUM AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-6001
Mailing Address - Country:US
Mailing Address - Phone:860-597-2627
Mailing Address - Fax:
Practice Address - Street 1:1316S ASYLUM AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-6001
Practice Address - Country:US
Practice Address - Phone:860-597-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional