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Individual

MS. DIANE MARIE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LADC

Contact information

Practice address
352 STATE ST, NORTH HAVEN, CT 06473-3108
(203) 781-4600
(203) 781-4624
Mailing address
100 GREENHILL TER, NEW HAVEN, CT 06515-1513
(203) 288-3344

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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