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NPI Code Detail

MEDICARE: MISS JESSICA ALLISON YOUNG

MEDICARE: MISS JESSICA ALLISON 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
1171M00000XCase Manager/Care CoordinatorOH
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.181671OH

General Provider Information

NPI Number : 1568185528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JESSICA ALLISON YOUNG
Provider Business Mailing Address
First Line : 526 MONTERAY AVE
Second Line :
City : KETTERING
State : OH
Zip : 45419-2253
Country : US
Telephone Number : 937-900-4142
Fax Number :
Provider Business Practice Location Address
First Line : 1825 COMMERCE CENTER BLVD
Second Line :
City : FAIRBORN
State : OH
Zip : 45324-6336
Country : US
Telephone Number : 937-376-8755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2022
Last Update Date : 12/22/2025

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Directions to “ MISS JESSICA ALLISON YOUNG ” Practice Location

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