Active NPI
Loretta Marie Young, BA,CADC
- Mental Health Counselor
- Waukegan, IL
National Provider Identifier
1447010202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 28020
- Practice address
- 3010 Grand Ave FL 2
Waukegan, IL 60085-2321 - Phone
- (847) 377-8247
- Fax
- (847) 984-5805
- NPI assigned
- Mar 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 28020 | IL | Primary |
Addresses
Primary practice location
3010 Grand Ave FL 2
Waukegan, IL 60085-2321
Mailing address
2643 Spruce Dr
North Chicago, IL 60064-1614
Phone (773) 701-2449
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28020 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712793600000",
"number": "1447010202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2643 SPRUCE DR",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600641614",
"telephone_number": "773-701-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 GRAND AVE FL 2",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600852321",
"telephone_number": "847-377-8247",
"fax_number": "847-984-5805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LORETTA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "BA,CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-20",
"last_updated": "2024-04-11",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "28020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.