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KELLY JANE YOUNG CRADC
NPI 1104588177
Clinic/Center - Rehabilitation, Substance Use Disorder in Joplin, MO

Active since October 07, 2021
501 S PENNSYLVANIA AVE, JOPLIN, MO 64801(417) 553-0043(417) 553-0081 Get Directions Write a Review

NPPES record last updated: October 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Jane Young Cradc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY JANE YOUNG CRADC (NPI 1104588177) is an individual rehabilitation, substance use disorder provider in Joplin, Missouri, licensed in Missouri (2821) and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1104588177
Entity TypeIndividualFemale
Primary Taxonomy261QR0405X
Provider Legal NameKELLY JANE YOUNGCredential: CRADC
Location Address501 S PENNSYLVANIA AVEJoplin, MO 64801-2286
Mailing Address501 S Pennsylvania AveJoplin, MO 64801-2286 · (417) 553-0043 · Fax (417) 553-0081
Phone(417) 553-0043
Fax(417) 553-0081
Sole ProprietorYes
Enumeration DateOctober 7, 2021
NPPES CertifiedOctober 7, 2021
✔ NPI 1104588177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
License✔ Licensed in MO · 2821
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 4486 (MO)
Also ListedPeer SpecialistTaxonomy 175T00000X · License 10017
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X · License 2821 (MO)
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X · License 2821 (MO)
501 S PENNSYLVANIA AVE, Joplin, MO 64801
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST JUDE HOME CARE OF THE FOUR STATES, LLC
In Home Supportive Care
501 S PENNSYLVANIA AVE
JOPLIN, MO 64801
Jasper County (417) 717-0594

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Young's NPI number?

The NPI number for Kelly Young is 1104588177. It was assigned to this individual provider in the NPPES registry on October 7, 2021.

Where is Kelly Young located?

Kelly Young practices at 501 S Pennsylvania Ave, Joplin, MO 64801. The listed phone number is (417) 553-0043.

What is Kelly Young's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Kelly Young was last updated on October 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.