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General NPI Number Information
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NPI Number | 1972634426
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Entity Type | Individual
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Provider Name | SARA DEHART-YOUNG MS, LPC, ATR
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 519 DR. MARTIN LUTHER KING, JR. DRIVE
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City | STARKVILLE
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State | MS
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Zip | 39759-2747
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Country | US
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Telephone | 662-323-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 15 TALLEY HO DR
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City | STARKVILLE
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State | MS
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Zip | 39759-2747
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Country | US
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Telephone | 662-320-3903
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1021779
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License Number State | MS
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