Individual
SARA J YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS CRMII QMHA CADCI
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8444
(503) 239-8400
Mailing address
194 WONDERLY DR, SAINT HELENS, OR 97051-1632
(971) 363-5685
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22-03-10374
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-20-112
OR
101YM0800X
Mental Health Counselor
19-QMHA-I-02752
OR
175T00000X
Peer Specialist
THW000003584
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-QMHA-I-02752
MHACBO
OR
01
—
21-CRM-II-0020
MHACBO
OR
01
—
22-03-10374
MHACBO
OR
01
—
THW000003584
OREGON HEALTH AUTHORITY
OR
Enumeration date
07/15/2019
Last updated
05/18/2022
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