Provider Demographics
NPI:1558029793
Name:YOUNG, KRISTEN N (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:N
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 1:2689 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8611
Mailing Address - Country:US
Mailing Address - Phone:859-537-9779
Mailing Address - Fax:859-537-9779
Practice Address - Street 1:2689 FRANKFORT RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8611
Practice Address - Country:US
Practice Address - Phone:859-537-9779
Practice Address - Fax:859-537-9779
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2563281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical