Provider Demographics
NPI:1912057316
Name:YOUNT, JAN SCOTT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:SCOTT
Last Name:YOUNT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5297 HOGAN CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-4713
Mailing Address - Country:US
Mailing Address - Phone:513-398-1074
Mailing Address - Fax:
Practice Address - Street 1:5750 GATEWAY STE 103
Practice Address - Street 2:TYLERSVILLE CROSSING
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1895
Practice Address - Country:US
Practice Address - Phone:513-779-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4510103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical