Healthcare Provider Details

I. General information

NPI: 1154285997
Provider Name (Legal Business Name): OVERCOME COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 E BEVERLY AVE STE B
KINGMAN AZ
86409-3564
US

IV. Provider business mailing address

812 TOPEKA ST
KINGMAN AZ
86401-6040
US

V. Phone/Fax

Practice location:
  • Phone: 928-753-9383
  • Fax:
Mailing address:
  • Phone: 949-391-8333
  • Fax: 949-391-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAWNDA NICOLE YOUNG
Title or Position: THERAPIST
Credential: MS
Phone: 949-391-8333