person
Ms. Kim Kory Young, MHTECHICIAN/LLMSW
Other Technician in Pontiac, Michigan
NPI 1083160790

Kim Kory Young is a Other Technician based in Pontiac, MI. Kim Kory Young practices in Pontiac, MI and has the professional credentials of MHTECHICIAN/LLMSW. The NPI Number for Kim Kory Young is 1083160790 and holds a License No. 1-04781 (Michigan).

The current practice location address for Kim Kory Young is 116 N Johnson St, Pontiac, MI and can be reached out via phone at 248-613-4098 and via fax at 248-622-4081. You can also correspond with Kim Kory Young through the mailing address at 116 N JOHNSON ST, PONTIAC, MI - 48341 (mailing address contact number: 248-613-4098).

Location: 116 N Johnson St, Pontiac, MI, 48341
person
Provider Profile Details
NPI Number
1083160790
Provider Name
Kim Kory Young
Credential
MHTECHICIAN/LLMSW
Provider Entity Type
Individual
Gender
Female
Address
116 N Johnson St, Pontiac, MI, 48341
Phone Number
248-613-4098
Fax Number
248-622-4081
Provider Enumeration Date
09/01/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
L148347 01 MI DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF HEALTH CARE SERVICES
institution
Provider Business Practice Location Address Details
Address
116 N Johnson St
City
State
Zip
48341-1330
Phone Number
248-613-4098
Fax Number
248-622-4081
person
Provider Business Mailing Address Details
Address
116 N Johnson St
City
State
Zip
48341
Phone Number
248-613-4098
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
(Michigan)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
person
Provider's Taxonomy Details 3
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Technician, Other
Speciality
-
Taxonomy
License No.
1-04781 (Michigan)
Definition
A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.
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