Provider Demographics
NPI:1245669944
Name:SINGH, YOUGEETA P
Entity type:Individual
Prefix:MRS
First Name:YOUGEETA
Middle Name:P
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 CHESTER CIR STE 103B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2270
Mailing Address - Country:US
Mailing Address - Phone:201-850-9592
Mailing Address - Fax:904-683-8350
Practice Address - Street 1:200 SAN SEBASTIAN VW
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-8695
Practice Address - Country:US
Practice Address - Phone:201-850-9592
Practice Address - Fax:904-683-8350
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 10184101YA0400X, 103K00000X
FLSW101841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst