Provider Demographics
NPI:1528430469
Name:YOUMANS, JONATHAN (MA, NCC, LPC, LCASA)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:YOUMANS
Suffix:
Gender:M
Credentials:MA, NCC, LPC, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-1922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:126 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-1922
Practice Address - Country:US
Practice Address - Phone:252-879-0091
Practice Address - Fax:252-257-8017
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22448101YA0400X
NC11888101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)