Provider Demographics
NPI:1801692652
Name:YORK, DUSTIN (RMHCI)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:YORK
Suffix:
Gender:
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7628 EXCITEMENT DR
Mailing Address - Street 2:
Mailing Address - City:REUNION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-6749
Mailing Address - Country:US
Mailing Address - Phone:520-465-0437
Mailing Address - Fax:
Practice Address - Street 1:530 DOG TRACK RD
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-6546
Practice Address - Country:US
Practice Address - Phone:407-900-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH27025101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health