Provider Demographics
NPI:1306024310
Name:YOUNG, PATRICIA ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
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 1:5110 S FLORIDA AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2512
Mailing Address - Country:US
Mailing Address - Phone:863-286-9592
Mailing Address - Fax:863-646-1055
Practice Address - Street 1:5110 S FLORIDA AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2512
Practice Address - Country:US
Practice Address - Phone:863-286-9592
Practice Address - Fax:863-646-1055
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health