Provider Demographics
NPI:1679993364
Name:YOUNT, CHARLOTTE LYNN (LPC, CTTS)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:LYNN
Last Name:YOUNT
Suffix:
Gender:F
Credentials:LPC, CTTS
Other - Prefix:MS
Other - First Name:CHARLOTTE
Other - Middle Name:WELLS
Other - Last Name:YOUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, CTTS
Mailing Address - Street 1:304 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9188
Mailing Address - Country:US
Mailing Address - Phone:601-316-2663
Mailing Address - Fax:
Practice Address - Street 1:304 PEBBLE CREEK DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9188
Practice Address - Country:US
Practice Address - Phone:601-316-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1103101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional