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Individual
MRS. STACI M YOUNG
Active
Individual
MRS. STACI M YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004431
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0497717615
VA PREMIER MEDICAID HMO
VA
05
—
1497717615
—
VA
01
—
294721
VALUE OPTIONS
VA
Enumeration date
09/11/2008
Last updated
03/24/2023
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