Provider Demographics
NPI:1215177704
Name:YOUNG, SANDEE K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDEE
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LOUELLA ST
Mailing Address - Street 2:
Mailing Address - City:BLACKFOOT
Mailing Address - State:ID
Mailing Address - Zip Code:83221-1609
Mailing Address - Country:US
Mailing Address - Phone:208-782-1322
Mailing Address - Fax:208-782-1322
Practice Address - Street 1:34 LOUELLA ST
Practice Address - Street 2:
Practice Address - City:BLACKFOOT
Practice Address - State:ID
Practice Address - Zip Code:83221-1609
Practice Address - Country:US
Practice Address - Phone:208-782-1322
Practice Address - Fax:208-782-1322
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-263321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical