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Individual

BRIAN JAMES YOUNGBLOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
320 CENTRAL PARK W, SUITE 1B, NEW YORK, NY 10025-7659
(443) 562-7137
Mailing address
320 CENTRAL PARK W, SUITE 1B, NEW YORK, NY 10025-7659
(443) 562-7137

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
078824
NY
1041C0700X
Clinical Social Worker
Primary
080443
NY

Other

Enumeration date
12/06/2012
Last updated
05/22/2014
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