Provider Demographics
NPI:1427918507
Name:MR. JON YOUTH SERVICES LLC
Entity type:Organization
Organization Name:MR. JON YOUTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-490-3148
Mailing Address - Street 1:223 LOCH LOW DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5567
Mailing Address - Country:US
Mailing Address - Phone:407-490-3148
Mailing Address - Fax:
Practice Address - Street 1:1455 GENE ST
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4840
Practice Address - Country:US
Practice Address - Phone:407-490-3148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)