Young, Kelly Marie

Young, Kelly Marie is an individual health care provider with primary practice located at 3364 Kolbe Rd , Lorain OH 44053-1628. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Young, Kelly Marie can be contacted via phone (815) 404-7589.

Contact Information

Primary practice address
3364 Kolbe Rd Lorain OH 44053-1628
Phone: (815) 404-7589
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 161869 Ohio

Profile Details

NPI number 1306144167
LBN Legal business name Young, Kelly Marie
Credentials LCDC II
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2011
Last updated Sep 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306144167 NPPES
Ohio MEDICAID 71562190
Ohio MEDICAID 58620001

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