Provider Demographics
NPI:1952942146
Name:YOUNG-SMITH, CARA (CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:YOUNG-SMITH
Suffix:
Gender:F
Credentials:CCC-SLP/L
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:HALFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19970 VOLTERA PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3793
Mailing Address - Country:US
Mailing Address - Phone:847-525-0707
Mailing Address - Fax:
Practice Address - Street 1:19970 VOLTERA PL
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3793
Practice Address - Country:US
Practice Address - Phone:847-525-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146014017235Z00000X
AK150335235Z00000X
OR016645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK150335OtherALASKA STATE LICENSURE
OR016645OtherOREGON STATE LICENSURE
IL146014017OtherILLINOIS STATE LICENSURE