MEDICARE: MRS. KRISTIE L YOUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	10348	SC

General Provider Information

NPI Number	:	1194993295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIE L YOUNG

Provider Business Mailing Address
First Line	:	4101 NORTHLAND CT
Second Line	:
City	:	INDIAN TRAIL
State	:	NC
Zip	:	28079-5640
Country	:	US
Telephone Number	:	720-272-4986
Fax Number	:

Provider Business Practice Location Address
First Line	:	1036 ASSEMBLY DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-6400
Country	:	US
Telephone Number	:	980-290-4510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	02/09/2026

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