Provider Demographics
NPI:1649320839
Name:YOUNG, LAURA B (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 TEAGUE CIR
Mailing Address - Street 2:
Mailing Address - City:EQUALITY
Mailing Address - State:AL
Mailing Address - Zip Code:36026-2706
Mailing Address - Country:US
Mailing Address - Phone:334-277-7955
Mailing Address - Fax:334-277-2919
Practice Address - Street 1:5760 CARMICHAEL PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2338
Practice Address - Country:US
Practice Address - Phone:334-277-7955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL709101YM0800X
AL122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist