Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Jane Young, CRADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1104588177

Kelly Jane Young, CRADC is an Addiction (Substance Use Disorder) Counselor in Joplin, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2021
Specialties on file
5
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Practice location Address checks out

501 S Pennsylvania Ave
Joplin, MO 64801-2286
Phone: (417) 553-0043
Fax: (417) 553-0081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X · Licence 2821 (MO)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 4486 (MO)
Peer Specialist Taxonomy 175T00000X · Licence 10017
Adult Mental Health Clinic/Center Taxonomy 261QM0850X · Licence 2821 (MO)
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X · Licence 2821 (MO)

Record details

NPI number1104588177
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRADC
Sole proprietorYes
NPI enumeratedOctober 7, 2021
Last updated in NPPESOctober 7, 2021
Certification dateOctober 7, 2021

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