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General NPI Number Information
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NPI Number | 1275497372
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Entity Type | Organization
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Legal Business Name | JORDAN T. YOUNG, NP IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 70 N WEST ST
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City | HOMER
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State | NY
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Zip | 13077-1033
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Country | US
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Telephone | 607-345-0824
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 353
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City | HOMER
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State | NY
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Zip | 13077-0353
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Country | US
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Telephone | 607-345-0824
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | JORDAN TAYLOR YOUNG
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Credential | PMHNP-BC
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Telephone | 607-345-0824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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