Provider Demographics
NPI:1558484816
Name:YOUNG, STEPHANIE JOY (MA, LCMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JOY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRICKETTS MILL RD
Mailing Address - Street 2:BRICKETTS MILL COUNSELING ASSOCIATES, INC.
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2396
Mailing Address - Country:US
Mailing Address - Phone:603-329-4379
Mailing Address - Fax:603-894-6360
Practice Address - Street 1:10 BRICKETTS MILL RD
Practice Address - Street 2:BRICKETTS MILL COUNSELING ASSOCIATES, INC.
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2396
Practice Address - Country:US
Practice Address - Phone:603-329-4379
Practice Address - Fax:603-894-6360
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH35916OtherNATL CERTIFIED CNSLR
NH174OtherLCMHC
NH1408793Y0NH01OtherANTHEM BCBS - BHN
NH30009546Medicaid
NH3941OtherDCYF AUTHORIZED PROVIDER