Stacey R. Young, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1934-C Issued in AR

Legal business name

STACEY R. YOUNG, PLLC

Practice address

215 N East Ave Ste 2
Fayetteville, AR 72701-5226

Phone

(479) 301-5290

NPI assigned

Aug 21, 2018

Last updated

Jun 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stacey Rae Young, LCSWNPI 1184665358

Title

Owner/Psychotherapist

Phone

(479) 387-0813

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacey Rae Young, LCSW

  • Clinical Social Worker
  • Fayetteville, AR
  • NPI 1184665358
  NPD Authorized official

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1760962484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4614",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727024614",
            "telephone_number": "479-301-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N EAST AVE STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015226",
            "telephone_number": "479-301-5290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 E Meadow St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727015357",
            "country_code": "US",
            "telephone_number": "479-387-0813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STACEY R. YOUNG, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "479-387-0813",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1934-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Francis House Nwa, Inc (Advanced Health & Wellness I)
• St Francis House Nwa, Inc (Owl Creek School Based Health Center)
• Devin Dean St. Clair, MD
• Kevin L St. Clair, M.D.
• Kyle St. Peter
• Adriana U. Stacey, M.D.
• Jennifer E Stafford, O.D.
• Miriam Stafford, M.S., CCC-SLP
• Travis Ryan Stafford, DPT
• Amanda Lauren Staggs, APRN

• Clinical Social Worker in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.