Provider Demographics
NPI:1861197584
Name:YOUNG, CAROLINE NYAMVULA (LGPC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:NYAMVULA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 MAPLE AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5601
Mailing Address - Country:US
Mailing Address - Phone:301-640-8639
Mailing Address - Fax:
Practice Address - Street 1:MBI HEALTH SERVICES
Practice Address - Street 2:2041 MARTIN LUTHER KING JR. AVENUE SE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020
Practice Address - Country:US
Practice Address - Phone:202-547-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00733101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health