| Doctor Name: | KURT YOUNGBERG |
| NPI Number: | 1023360104 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSW |
| License Number: | 8375190-3502 |
| Business Practice Address: | 248 E 13800 S #4 Draper, UT - 840205010 |
| Business Phone Number: | 8018161801 |
| Business Fax Number: | 8015010249 |
| Mailing Address: | 248 E 13800 S, #4 DRAPER |
| State: | UT |
| Postal Code: | 840205010 |
| Phone Number: | 8018161801 |
| Fax Number: | 8015010249 |
| NPI Enumeration Date: | 10/12/2012 |
| NPI Last Update Date: | 03/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 8375190-3502 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |