Provider Demographics
NPI:1912926270
Name:YOUNGS, KATHLEEN A (MA, LPC, LIMHP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:YOUNGS
Suffix:
Gender:F
Credentials:MA, LPC, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 974
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69363-0974
Mailing Address - Country:US
Mailing Address - Phone:308-631-8647
Mailing Address - Fax:
Practice Address - Street 1:955 COUNTRY CLUB RD STE B6
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-1765
Practice Address - Country:US
Practice Address - Phone:308-631-8647
Practice Address - Fax:308-632-5809
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1719101YM0800X
NE1036101YM0800X
NELIMHP 344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025397600Medicaid