Provider Demographics
NPI:1972225522
Name:YOUNGER, ERICA BROOKE (BCABA)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:BROOKE
Last Name:YOUNGER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 MARKEL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3008
Mailing Address - Country:US
Mailing Address - Phone:804-612-1947
Mailing Address - Fax:
Practice Address - Street 1:5311 MARKEL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3008
Practice Address - Country:US
Practice Address - Phone:804-612-1947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000463106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst