Healthcare Provider Details

I. General information

NPI: 1730885211
Provider Name (Legal Business Name): JOLENE YOUNG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 WALNUT ST
FRANKFORT KY
40601-3240
US

IV. Provider business mailing address

108 SHUTTLE DR
GEORGETOWN KY
40324-8988
US

V. Phone/Fax

Practice location:
  • Phone: 502-209-8024
  • Fax:
Mailing address:
  • Phone: 859-707-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number257354
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: