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General NPI Number Information
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NPI Number | 1003830910
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Entity Type | Individual
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Provider Name | KAREN YOUNG CADC III, CCS-G
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 141A COTTONWOOD AVE
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City | HARTLAND
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State | WI
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Zip | 53029-2014
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Country | US
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Telephone | 262-367-5104
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Fax | 262-369-9569
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Provider Business Mailing Address
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Address Line | 285 N JANACEK RD
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City | BROOKFIELD
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State | WI
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Zip | 53045-6102
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Country | US
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Telephone | 262-641-9050
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Fax | 262-641-9126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1950
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12058
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License Number State | WI
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