MEDICARE: JASMINE N. YOUNG ED.S, LPCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	265885	KY

General Provider Information

NPI Number	:	1528881240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE N. YOUNG ED.S, LPCA

Provider Business Mailing Address
First Line	:	10620 MORAINE CIR APT 208
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-4601
Country	:	US
Telephone Number	:	502-612-5970
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 ELLISON AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1657
Country	:	US
Telephone Number	:	502-694-9488
Fax Number	:	502-276-0926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2024
Last Update Date	:	11/01/2024

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