Organization
CLY PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER L YOUNG LISW (OWNER/SERVICE PROVIDER)
(513) 488-9149
Entity
Organization
Contact information
Practice address
548 TUSCULUM AVE, CINCINNATI, OH 45226-1774
(513) 488-9149
Mailing address
8350 TIDEWATER CT, CINCINNATI, OH 45255-4468
(513) 488-9149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231050
—
OH
Enumeration date
01/26/2021
Last updated
01/26/2021
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