Provider Demographics
NPI:1003488008
Name:YOUNG, STEVEN DANIEL (MA, LADC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DANIEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MA, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12250 OTCHIPWE AVE N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-8514
Mailing Address - Country:US
Mailing Address - Phone:651-500-2091
Mailing Address - Fax:
Practice Address - Street 1:1715 TOWER DR W STE 100
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-7609
Practice Address - Country:US
Practice Address - Phone:651-390-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-11
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health