Provider Demographics
NPI:1053653402
Name:YOUNG, STEFANIE M (LPCC)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S CLEVELAND MASSILLON RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-9204
Mailing Address - Country:US
Mailing Address - Phone:307-544-8443
Mailing Address - Fax:833-974-2062
Practice Address - Street 1:2295 W MARKET ST # STREETJ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6944
Practice Address - Country:US
Practice Address - Phone:330-730-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
E1700238101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0406219Medicaid
OHE.1700238OtherOHIO ELICENSE PROFESSIONAL LICENSURE