Provider Demographics
NPI:1528316189
Name:YOUNG, SARAH ELIZABETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S. STATE STREET
Mailing Address - Street 2:SUITE 13
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464
Mailing Address - Country:US
Mailing Address - Phone:616-772-1733
Mailing Address - Fax:
Practice Address - Street 1:300 S. STATE STREET
Practice Address - Street 2:SUITE 13
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464
Practice Address - Country:US
Practice Address - Phone:616-772-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional