Provider Demographics
NPI:1396077376
Name:YOUNG, KAREN (LBHP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 NW 146TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2446
Mailing Address - Country:US
Mailing Address - Phone:409-409-3220
Mailing Address - Fax:
Practice Address - Street 1:300 NW 146TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2446
Practice Address - Country:US
Practice Address - Phone:409-409-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0000000Medicaid
OK000000000Medicaid