Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY JANE YOUNG, CRADC
Active Sole ProprietorKELLY JANE YOUNG, CRADC is a Substance Use Disorder Rehabilitation Facility healthcare provider located in JOPLIN, Missouri. NPI 1104588177 is currently active in the NPPES registry. Verify at CMS.
Substance Use Disorder Rehabilitation Facility · JOPLIN, MO
Registration Details
- NPI Number
- 1104588177
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 7, 2021 (4.8897220462433 yrs)
- Last Updated
- Oct 7, 2021
- Licenses
-
4486 (MO)100172821 (MO)2821 (MO)2821 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
501 S PENNSYLVANIA AVEJOPLIN, MO, 648012286Browse MO providers · Browse ZIP 64801
- Phone
- 4175530043
- Fax
- 4175530081
- Primary Specialty
-
Substance Use Disorder Rehabilitation Facility
261QR0405X
- Additional Specialty
- Peer Specialist
- Additional Specialty
- Adult Mental Health Clinic
- Additional Specialty
- Adolescent and Children Mental Health Clinic
- Additional Specialty
- Substance Use Disorder Rehabilitation Facility
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.