Individual provider · Type 1 NPI
Jessica Young, LPC, CMHIMP
Professional Counselor · Walworth, WI
NPI number
1902200108
Active
Practice location
129 Kenosha St
Walworth, WI 53184
Mailing address
PO Box 252
Walworth, WI 53184
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 5479-125 (WI) |
Professional Counselor: Definition to come...
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About NPI 1902200108
Jessica Young, LPC, CMHIMP's National Provider Identifier is 1902200108, issued on Oct 16, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Walworth, WI. The record was last updated on Nov 16, 2021.