Healthcare Provider Details

I. General information

NPI: 1518778604
Provider Name (Legal Business Name): NORTH STAR MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 HARVARD AVE
PALMERTON PA
18071-1226
US

IV. Provider business mailing address

261 HARVARD AVE
PALMERTON PA
18071-1226
US

V. Phone/Fax

Practice location:
  • Phone: 484-860-0069
  • Fax:
Mailing address:
  • Phone: 484-860-0069
  • Fax:

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: TIFFANI MARIE YOUNG
Title or Position: OWNER
Credential: LPC
Phone: 484-860-0069