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Kelly Jane Young, CRADC
Substance Use Disorder Rehabilitation Clinic/Center in Joplin, Missouri
NPI 1104588177

Kelly Jane Young is a Substance Use Disorder Rehabilitation Clinic/Center based in Joplin, MO and is specialized in Rehabilitation, Substance Use Disorder. Kelly Jane Young practices in Joplin, MO and has the professional credentials of CRADC. The NPI Number for Kelly Jane Young is 1104588177 and holds a License No. 4486 (Missouri).

The current practice location address for Kelly Jane Young is 501 S Pennsylvania Ave, Joplin, MO and can be reached out via phone at 417-553-0043 and via fax at 417-553-0081. You can also correspond with Kelly Jane Young through the mailing address at 501 S PENNSYLVANIA AVE, JOPLIN, MO - 64801-2286 (mailing address contact number: 417-553-0043).

Location: 501 S Pennsylvania Ave, Joplin, MO, 64801-2286
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104588177
Provider Name
Kelly Jane Young
Credential
CRADC
Provider Entity Type
Individual
Gender
Female
Address
501 S Pennsylvania Ave, Joplin, MO, 64801-2286
Phone Number
417-553-0043
Fax Number
417-553-0081
Provider Enumeration Date
10/07/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
501 S Pennsylvania Ave
City
Joplin
State
Missouri
Zip
64801-2286
Phone Number
417-553-0043
Fax Number
417-553-0081
person
Provider Business Mailing Address Details
Address
501 S Pennsylvania Ave
City
Joplin
State
Missouri
Zip
64801-2286
Phone Number
417-553-0043
Fax Number
417-553-0081
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
2821 (Missouri)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
2821 (Missouri)
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
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
2821 (Missouri)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
10017 ()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
4486 (Missouri)
Definition
Definition to come...
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