Ms Kim Kory Young, MHTECHICIAN/LLMSW is a
Technician, Other based in Pontiac, Michigan. Ms Kim Kory Young is licensed to practice in Michigan (license number L148347) and her current practice location is
116 N Johnson St, Pontiac, Michigan. She can be reached at her office (for appointments etc.) via phone at
(248) 613-4098.
NPI number for Ms Kim Kory Young is 1083160790 and her current mailing address is 116 N Johnson St, Pontiac, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1083160790.
Healthcare Provider's Profile
| Full Name | Ms Kim Kory Young |
|---|
| Gender | Female |
|---|
| Speciality | Technician, Other |
|---|
| Location | 116 N Johnson St, Pontiac, Michigan |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1083160790
- Provider Enumeration Date: 09/01/2016
- Last Update Date: 04/10/2020
Medical Identifiers
Medical identifiers for Ms Kim Kory Young such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083160790 | NPI | - | NPPES |
| L148347 | Other | MI | DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF HEALTH CARE SERVICES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1-04781 (Michigan) | Secondary |
| 175T00000X | Peer Specialist | (Michigan) | Secondary |
| 175T00000X | Peer Specialist | (* (Not Available)) | Secondary |
| 247200000X | Technician, Other | L148347 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kim Kory Young is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Kim Kory Young, MHTECHICIAN/LLMSW
116 N Johnson St,
Pontiac, MI 48341
Ph: (248) 613-4098 | Ms Kim Kory Young, MHTECHICIAN/LLMSW
116 N Johnson St,
Pontiac, MI 48341-1330
Ph: (248) 613-4098 |
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