Provider Demographics
NPI:1144931973
Name:YOUNGBLOOD COUNSELING AND CONSULTATION SERVICES LLC
Entity type:Organization
Organization Name:YOUNGBLOOD COUNSELING AND CONSULTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LICDC
Authorized Official - Phone:513-505-4145
Mailing Address - Street 1:7753 BITTEROOT LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1172
Mailing Address - Country:US
Mailing Address - Phone:513-505-4145
Mailing Address - Fax:513-445-8286
Practice Address - Street 1:690 NORTHLAND BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3214
Practice Address - Country:US
Practice Address - Phone:513-549-2681
Practice Address - Fax:513-445-8286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty