Healthcare Provider Details

I. General information

NPI: 1275272619
Provider Name (Legal Business Name): JOHN PAUL YOUNES MA, LMHCA, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 LINCOLNWAY E
MISHAWAKA IN
46544-2016
US

IV. Provider business mailing address

1122 FOSTER ST
SOUTH BEND IN
46617-1238
US

V. Phone/Fax

Practice location:
  • Phone: 574-314-5987
  • Fax:
Mailing address:
  • Phone: 574-303-7403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number88002323A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0018420
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: