Individual
KELLY JANE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRADC
Contact information
Practice address
501 S PENNSYLVANIA AVE, JOPLIN, MO 64801-2286
(417) 553-0043
(417) 553-0081
Mailing address
501 S PENNSYLVANIA AVE, JOPLIN, MO 64801-2286
(417) 553-0043
(417) 553-0081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4486
MO
175T00000X
Peer Specialist
10017
—
261QM0850X
Adult Mental Health Clinic/Center
2821
MO
261QM0855X
Adolescent and Children Mental Health Clinic/Center
2821
MO
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
2821
MO
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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