Provider Demographics
NPI:1013677301
Name:YOUNG, KATELYN (MS, PLPC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 E ALICE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712-2004
Mailing Address - Country:US
Mailing Address - Phone:217-240-0091
Mailing Address - Fax:
Practice Address - Street 1:325 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-2123
Practice Address - Country:US
Practice Address - Phone:417-942-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health