Healthcare Provider Details

I. General information

NPI: 1235062886
Provider Name (Legal Business Name): RENEE YOUNG MS, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RENEE YOUN MS, LMHC

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27346 EAST DR
BONITA SPRINGS FL
34135-4933
US

IV. Provider business mailing address

27346 EAST DR
BONITA SPRINGS FL
34135-4933
US

V. Phone/Fax

Practice location:
  • Phone: 239-980-8761
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH3998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: