Provider Demographics
NPI:1427890722
Name:YOUNG, MARSHA LYNN (LCAC)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LCAC
Other - Prefix:MISS
Other - First Name:MARSHA
Other - Middle Name:LYNN
Other - Last Name:MCCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:318 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534-2075
Mailing Address - Country:US
Mailing Address - Phone:785-285-1038
Mailing Address - Fax:
Practice Address - Street 1:913 DAKOTA ST RM 18
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534-2008
Practice Address - Country:US
Practice Address - Phone:785-285-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9998678101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty