Basic Information
| Provider Information | |||||||||
| NPI: | 1275970741 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUNGER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | MCGEE | ||||||||
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| Credential: | BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2145 CENTENNIAL PLZ | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974012421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414856340 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 550 RIVER RD | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974043212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417432611 | ||||||||
| FaxNumber: | 5418680340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2013 | ||||||||
| LastUpdateDate: | 06/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175T00000X | 1639231715 | OR | N | 101Y00000X | 323PO0000X | OR | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | 1275970741 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.