Provider Demographics
NPI:1609165729
Name:YOUNG, COURTLAND JAMES III (LCSW)
Entity type:Individual
Prefix:MR
First Name:COURTLAND
Middle Name:JAMES
Last Name:YOUNG
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GREENRIDGE TER
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2653
Mailing Address - Country:US
Mailing Address - Phone:203-879-7035
Mailing Address - Fax:
Practice Address - Street 1:3 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1735
Practice Address - Country:US
Practice Address - Phone:203-758-3216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical