MEDICARE: DARRELL TARRELL YOUNGBLOOD PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61661385	WA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	406045	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1143578	TX
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10027568	OR
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	206593	LA
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	321232	AZ
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP030665	PA
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11027857	FL
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	83048	NM
10	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0102818-C-NP	CO
11	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024189159	VA
12	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4704435172	MI

General Provider Information

NPI Number	:	1679252027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL TARRELL YOUNGBLOOD PMHNP-BC

Provider Business Mailing Address
First Line	:	1901 MANHATTAN BLVD BLDG D
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-3583
Country	:	US
Telephone Number	:	504-544-1061
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 GRETNA BLVD STE A
Second Line	:
City	:	GRETNA
State	:	LA
Zip	:	70053-4995
Country	:	US
Telephone Number	:	504-544-1061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2023
Last Update Date	:	01/28/2026

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