Individual
MS. DIANE MARIE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000542
CT
1041C0700X
Clinical Social Worker
Primary
005227
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082286
—
CT
05
—
004235083
—
CT
05
—
008022626
—
CT
01
—
022672
VMC AFFILIATE
CT
01
—
140005227CT01
ANTHEM BCBS
CT
01
—
300000542CT01
ANTHEM BCBS
CT
01
—
303733
MHN
CT
01
—
476270000
MAGELLAN
CT
05
—
500000315
—
CT
01
—
513954
VALUE OPTIONS
CT
01
—
7944589
AETNA
CT
Enumeration date
05/23/2007
Last updated
01/24/2022
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