Provider Demographics
NPI:1780608596
Name:YOUNG, STEPHANIE MARIE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 MOUNT TABOR RD
Mailing Address - Street 2:STE. 203
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6427
Mailing Address - Country:US
Mailing Address - Phone:812-949-4900
Mailing Address - Fax:812-949-4903
Practice Address - Street 1:821 MOUNT TABOR RD
Practice Address - Street 2:STE. 203
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6427
Practice Address - Country:US
Practice Address - Phone:812-949-4900
Practice Address - Fax:812-949-4903
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001640A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health