Basic Information
Provider Information
NPI: 1669505426
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOUNT
FirstName: CECIL
MiddleName: EVANS
NamePrefix: MR.
NameSuffix:  
Credential: M.A., L.C.A.S., CCS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 154 MEDICAL PARK LOOP
Address2:  
City: SYLVA
State: NC
PostalCode: 287795222
CountryCode: US
TelephoneNumber: 8286313973
FaxNumber: 8286319280
Practice Location
Address1: 154 MEDICAL PARK LOOP
Address2:  
City: SYLVA
State: NC
PostalCode: 287795222
CountryCode: US
TelephoneNumber: 8286313973
FaxNumber: 8286319280
Other Information
ProviderEnumerationDate: 03/13/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X351NCY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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