Organization
STACEY R. YOUNG, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY RAE YOUNG LCSW (OWNER/PSYCHOTHERAPIST)
(479) 387-0813
Entity
Organization
Contact information
Practice address
215 N EAST AVE STE 2, FAYETTEVILLE, AR 72701-5226
(479) 301-5290
Mailing address
PO BOX 4614, FAYETTEVILLE, AR 72702-4614
(479) 301-5290
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1934-C
AR
Other
Enumeration date
08/21/2018
Last updated
06/11/2020
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