Provider Demographics
NPI:1336025568
Name:YOUNGBLOOD, JOCELYN ELAINE
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:ELAINE
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JOCELYN
Other - Middle Name:ELAINE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 FLORA FIELD DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-0180
Mailing Address - Country:US
Mailing Address - Phone:843-521-7910
Mailing Address - Fax:
Practice Address - Street 1:103 FLORA FIELD DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-0180
Practice Address - Country:US
Practice Address - Phone:843-521-7910
Practice Address - Fax:843-521-7910
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician