DR. KIMBERLY J YOUNGBLOOD LICDC ICDAC NPI 1043517451

NPI Information

NPI: 1043517451
Provider Name: DR. KIMBERLY J YOUNGBLOOD, LICDC, ICDAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
690 NORTHLAND BLVD
CINCINNATI, OH
ZIP 45240
Phone: (513) 549-2681
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DR. Kimberly J Youngblood, LICDC, ICDAC is an addiction (substance use disorder) counselor in Cincinnati, OH. DR. Kimberly J Youngblood, LICDC, ICDAC NPI is 1043517451. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

690 NORTHLAND BLVD
CINCINNATI, OH
ZIP 45240-214
Phone: (513) 549-2681
Fax: (513) 445-8286

The enumeration date for this NPI number is 2/21/2011 and was last updated on 7/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	081242	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0334355	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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