MEDICARE: JEAN F YOUNGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	35001547A	IN
2	106H00000X	Marriage & Family Therapist	35001547A	IN

General Provider Information

NPI Number	:	1134183452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN F YOUNGER

Provider Business Mailing Address
First Line	:	3500 DEPAUW BLVD
Second Line	:	SUITE 2052
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1170
Country	:	US
Telephone Number	:	317-731-4923
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 DEPAUW BLVD
Second Line	:	SUITE 2052
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1170
Country	:	US
Telephone Number	:	317-731-4923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	08/11/2011

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Directions to “ JEAN F YOUNGER ” Practice Location

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