Provider Demographics
NPI:1528778503
Name:YOUNGE, FREDERICK GODFREY (CSW)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:GODFREY
Last Name:YOUNGE
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14120 W SIDE BLVD APT 306
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6219
Mailing Address - Country:US
Mailing Address - Phone:240-643-0482
Mailing Address - Fax:
Practice Address - Street 1:1304 N CAPITOL ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3360
Practice Address - Country:US
Practice Address - Phone:202-800-4387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty