Provider Demographics
NPI:1346866647
Name:YOUNG, KATELYNN (LPC)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-0344
Mailing Address - Country:US
Mailing Address - Phone:501-450-6350
Mailing Address - Fax:501-358-4932
Practice Address - Street 1:1312 DONAGHEY AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3807
Practice Address - Country:US
Practice Address - Phone:501-450-6350
Practice Address - Fax:501-358-4932
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2008109101YM0800X
ARP2208013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health