Provider Demographics
NPI:1003123068
Name:YOUNG, ADIA SMITH (LMHC)
Entity Type:Individual
Prefix:
First Name:ADIA
Middle Name:SMITH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 S DIXIE HWY
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1800
Mailing Address - Country:US
Mailing Address - Phone:786-269-3728
Mailing Address - Fax:786-245-7202
Practice Address - Street 1:15715 S DIXIE HWY
Practice Address - Street 2:SUITE 307
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1800
Practice Address - Country:US
Practice Address - Phone:786-269-3728
Practice Address - Fax:786-245-7202
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health