Individual ProviderClark G YoungCounselorBehavioral Health & Social Service ProvidersPractice Address10373 NE Hancock St, Portland, OR 97220-3873(503) 253-6754(337) 794-3936PECOS EnrollmentBased on the most recent information from CMS, provider Clark G Young does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1184083438Provider TypeIndividualFull NameYoung, Clark GCredentialM.S., QMHPGenderFemaleSole ProprietorNoEnumeration Date2/15/2016Last Updated4/27/2023Contact InformationPractice LocationPractice Address10373 NE Hancock St, Portland, OR 97220-3873Phone(503) 253-6754FaxUnlisted FaxMailing LocationMailing Address2361 SE 116th Ave, Portland, OR 97216-4016Phone(337) 794-3936FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseR8305OregonCode101Y00000XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer