Provider Demographics
NPI:1497310940
Name:YOUNG, DEBRA A (LPC, NCC, LIMHP, CH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPC, NCC, LIMHP, CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 W THAYER AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3784
Mailing Address - Country:US
Mailing Address - Phone:701-325-0303
Mailing Address - Fax:
Practice Address - Street 1:602 W THAYER AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3784
Practice Address - Country:US
Practice Address - Phone:701-325-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND976-9-1-18A101YM0800X
ND976-9-1-18101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health