Provider Demographics
NPI:1588069348
Name:BROWN-YOUNG, REBECCA (PMHNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BROWN-YOUNG
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10484 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14111-9409
Mailing Address - Country:US
Mailing Address - Phone:716-337-3056
Mailing Address - Fax:716-337-3056
Practice Address - Street 1:10484 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH COLLINS
Practice Address - State:NY
Practice Address - Zip Code:14111-9409
Practice Address - Country:US
Practice Address - Phone:716-680-7163
Practice Address - Fax:716-680-7163
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY472010163WP0808X
NYF401827363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health