Youngblood, John

Youngblood, John is an individual health care provider with primary practice located at 120 Maple St Suite 219, Springfield MA 01103-2203. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Youngblood, John can be contacted via phone (413) 737-3730.

Contact Information

Primary practice address
120 Maple St Suite 219 Springfield MA 01103-2203
Phone: (413) 737-3730
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1424 Massachusetts

Profile Details

NPI number 1518087329
LBN Legal business name Youngblood, John
Credentials PSYCHOLOGIST
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518087329 NPPES
Massachusetts Other 0300050 MBHP
Massachusetts MEDICAID 1300881 MBHP

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