Individual
KEITH YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
175 UNION ST STE C, BANGOR, ME 04401-6116
(207) 951-7811
(888) 972-1920
Mailing address
175 UNION ST STE C, BANGOR, ME 04401-6116
(207) 951-7811
(888) 972-1920
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC2353
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100029
ANTHEM
ME
05
—
286460099
—
ME
Enumeration date
12/11/2006
Last updated
03/23/2020
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