Healthcare Provider Details

I. General information

NPI: 1851545016
Provider Name (Legal Business Name): MS. ASHLEY YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 WEST AVE # 113197
STAMFORD CT
06902-9993
US

IV. Provider business mailing address

317 WEST AVE # 113197
STAMFORD CT
06902-9993
US

V. Phone/Fax

Practice location:
  • Phone: 347-327-7524
  • Fax: 347-778-7784
Mailing address:
  • Phone: 347-327-7524
  • Fax: 347-778-7784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405647-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number161054
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number66743
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: