Provider Demographics
NPI:1871142257
Name:YOUNG, AMY M (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
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:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:270-858-6655
Mailing Address - Fax:270-858-4607
Practice Address - Street 1:931 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:CECILLIA
Practice Address - State:KY
Practice Address - Zip Code:42724-7614
Practice Address - Country:US
Practice Address - Phone:270-858-6655
Practice Address - Fax:270-858-4607
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2571471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical