Provider Demographics
NPI:1245686039
Name:YOUNG, DANA
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:YOUNG
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 1:1639 FORUM
Mailing Address - Street 2:SUITE #7
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-712-8821
Mailing Address - Fax:561-712-8070
Practice Address - Street 1:1639 FORUM
Practice Address - Street 2:SUITE #7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-712-8821
Practice Address - Fax:561-712-8070
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2019-05-15
Deactivation Date:2019-01-10
Deactivation Code:
Reactivation Date:2019-05-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator