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Contact Information

MIRRANDIA YOUNG, LICSW
570 SIDETRACK RD
BRIDGEPORT, WV26330
 Phone: 304-646-6630
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for MIRRANDIA YOUNG · (Female)

NPI Number 1396498523
Status Active
Credentials LICSW (Licensed Independent Clinical Social Worker)
Entity Individual
Enumeration date 01/28/2022
Last updated 01/28/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • WV License # DP00945113
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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