Provider Demographics
NPI:1346524964
Name:YOUNT, DEANN JENIFER (LCSW)
Entity Type:Individual
Prefix:
First Name:DEANN
Middle Name:JENIFER
Last Name:YOUNT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEANN
Other - Middle Name:
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:227 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1952
Mailing Address - Country:US
Mailing Address - Phone:636-931-2700
Mailing Address - Fax:636-931-5304
Practice Address - Street 1:4300 GRAVOIS RD
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-2304
Practice Address - Country:US
Practice Address - Phone:636-321-0150
Practice Address - Fax:636-375-5157
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0055991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO112240020OtherMEDICARE PTAN