Provider Demographics
NPI:1609817345
Name:YOUNG, SHUNITA SIMONE (LMSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:SHUNITA
Middle Name:SIMONE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BILLIE BESS LN
Mailing Address - Street 2:APT 116
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1303
Mailing Address - Country:US
Mailing Address - Phone:936-718-6807
Mailing Address - Fax:
Practice Address - Street 1:510 BILLIE BESS LN
Practice Address - Street 2:APT 116
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1303
Practice Address - Country:US
Practice Address - Phone:936-718-6807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1887-M101YM0800X
TX525971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health