Provider Demographics
NPI:1053896894
Name:YOUNG-PRICE, LEAH STACY (MA,LPC,NCC,CCMHC)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:STACY
Last Name:YOUNG-PRICE
Suffix:
Gender:F
Credentials:MA,LPC,NCC,CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 INDIAN RIVER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5252
Mailing Address - Country:US
Mailing Address - Phone:757-472-4982
Mailing Address - Fax:757-282-5929
Practice Address - Street 1:5505 INDIAN RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5252
Practice Address - Country:US
Practice Address - Phone:757-472-4982
Practice Address - Fax:757-282-5929
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007861101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health