Individual provider · Type 1 NPI
Kelly Jane Young, CRADC
Substance Use Disorder Rehabilitation Clinic/Center · Joplin, MO
NPI number
1104588177
Active
Practice location
501 S Pennsylvania Ave
Joplin, MO 64801-2286
Fax (417) 553-0081
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4486 (MO) |
| Peer Specialist | 175T00000X | 10017 |
| Adult Mental Health Clinic/Center | 261QM0850X | 2821 (MO) |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 2821 (MO) |
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 2821 (MO) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
Another provider at this address
About NPI 1104588177
Kelly Jane Young, CRADC's National Provider Identifier is 1104588177, issued on Oct 7, 2021. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Joplin, MO. The record was last updated on Oct 7, 2021.