Healthcare Provider Details

I. General information

NPI: 1639015985
Provider Name (Legal Business Name): ANTHONY JAMES YOUNKIN M.ED., LMHCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W HIGH ST
ELKHART IN
46516-2827
US

IV. Provider business mailing address

311 W HIGH ST
ELKHART IN
46516-2827
US

V. Phone/Fax

Practice location:
  • Phone: 574-262-3597
  • Fax:
Mailing address:
  • Phone: 574-262-3597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003170A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: