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Contact Information

CHARISSA YOUNG, LCSW
3001 WARRIOR LN
POPLAR BLUFF, MO63901
 Phone: 573-686-1200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for CHARISSA YOUNG · (Female)

NPI Number 1033522412
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 06/03/2014
Last updated 06/16/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2018019792
  • MO Medicaid 1033522412
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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