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Organization

PHARAOH MIND

Active
Other names
Pharaoh Mind
Organization subpart
No

Provider details

NPI number
Authorized official
DARRELL YOUNGBLOOD PMHNP-BC (PSYCHIATRIC NP)
(504) 544-1061
Entity
Organization

Contact information

Practice address
165 N VILLAGE AVE STE 12, ROCKVILLE CENTRE, NY 11570-3701
(504) 544-1061
Mailing address
750 W DIMOND BLVD STE 103NO239, ANCHORAGE, AK 99515-1515
(504) 544-1061

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
406045
NURSE PRACTITIONER-PSYCHIATRY
NY
Enumeration date
03/28/2025
Last updated
03/28/2025
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