Healthcare Provider Details

I. General information

NPI: 1205790003
Provider Name (Legal Business Name): ARNATHA JEANINE YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 NW 87TH TER STE C-210
KANSAS CITY MO
64153-3720
US

IV. Provider business mailing address

231 S BEMISTON AVE STE 850
SAINT LOUIS MO
63105-1920
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone: 314-325-6807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2025044197
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: