Mary Ellen Youngblood, M.ED., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401010289 Issued in MI

Practice address

403 N Broad St
Adrian, MI 49221-2127

Phone

(517) 266-8500

Fax

(866) 223-1175

NPI assigned

Sep 17, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Still Waters Counseling, LLC

  • Mental Health Counselor
  • Adrian, MI
  • NPI 1285781195
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1477749109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N BROAD ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212127",
            "telephone_number": "517-266-8500",
            "fax_number": "866-223-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N BROAD ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212127",
            "telephone_number": "517-266-8500",
            "fax_number": "866-223-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401010289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie K Yaroch, D.O.
• Kimberly Yoder, LLMSW
• Jamie Young
• Kiersten Young
• Sheila Ann Young
• Kristina Mae Younglove, CHW
• Richard Bennett Youngs, DDS
• Erin Maureen Yuen, LLMSW
• Jennifer Nichole Zadorski, LLBSW
• Caroline Marie Zavala, MA, LPC, IMH-E(II)

• Mental Health Counselor in Adrian, MI
• Providers in Adrian, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.