| Stacey R. Young, Pllc | |
|
215 N East Ave Ste 2 Fayetteville AR 72701-5226 | |
| (479) 301-5290 | |
| Not Available |
| Full Name | Stacey R. Young, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 215 N East Ave Ste 2, Fayetteville, Arkansas |
| Authorized Official Name and Position | Stacey Rae Young (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 4793870813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey R. Young, Pllc Po Box 4614 Fayetteville AR 72702-4614 Ph: (479) 301-5290 | Stacey R. Young, Pllc 215 N East Ave Ste 2 Fayetteville AR 72701-5226 Ph: (479) 301-5290 |
| NPI Number | 1760962484 |
|---|---|
| Provider Enumeration Date | 08/21/2018 |
| Last Update Date | 06/11/2020 |
| Certification Date | 06/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760962484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1934-C (Arkansas) | Primary |
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