MEDICARE: KAYLEE 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	106S00000X	Behavior Technician
2	101YM0800X	Mental Health Counselor	14164	NE

General Provider Information

NPI Number	:	1750031902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE YOUNG

Provider Business Mailing Address
First Line	:	11837 MIRACLE HILLS DR STE 102
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-4418
Country	:	US
Telephone Number	:	402-804-3229
Fax Number	:

Provider Business Practice Location Address
First Line	:	11837 MIRACLE HILLS DR STE 102
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-4418
Country	:	US
Telephone Number	:	402-804-3229
Fax Number	:

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

Provider Enumeration Date	:	03/28/2022
Last Update Date	:	06/17/2025

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Directions to “ KAYLEE YOUNG ” Practice Location

Language	Start Address	Practice Location

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