Provider Demographics
NPI:1336477876
Name:YOUNG, STEPHANIE (MS, LPCC-S)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3952 N BEND RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-3521
Mailing Address - Country:US
Mailing Address - Phone:513-661-8336
Mailing Address - Fax:513-661-8111
Practice Address - Street 1:3952 N BEND RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-3521
Practice Address - Country:US
Practice Address - Phone:513-661-8336
Practice Address - Fax:513-661-8111
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE7911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional