Provider Demographics
NPI:1902679087
Name:YOUNG, MEGAN (RMHCI)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4977 39TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-5701
Mailing Address - Country:US
Mailing Address - Phone:386-284-4982
Mailing Address - Fax:
Practice Address - Street 1:10245 CENTURION PKWY N STE 205
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-2808
Practice Address - Country:US
Practice Address - Phone:386-284-4982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health