Pharaoh Mind

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PHARAOH MIND

Doing business as

Pharaoh Mind

Practice address

165 N Village Ave Ste 12
Rockville Centre, NY 11570-3701

Phone

(504) 544-1061

NPI assigned

Mar 28, 2025

Last updated

Mar 28, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Darrell Youngblood, PMHNP-BCNPI 1679252027

Title

Psychiatric NP

Phone

(504) 544-1061

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pharaoh Mind Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darrell Tarrell Youngblood, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gretna, LA
  • NPI 1679252027

  Single Specialty

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1568265221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W DIMOND BLVD STE 103NO239",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151515",
            "telephone_number": "504-544-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 12",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703701",
            "telephone_number": "504-544-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARAOH MIND",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "PSYCHIATRIC NP",
        "authorized_official_telephone_number": "504-544-1061",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER-PSYCHIATRY",
            "identifier": "406045",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharaoh Mind",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Ann Pestrak, APRN
• Jaime Robin Petcove, M.S. CCC-SLP
• Richard Peters, M.D.
• Catherine Evelyn Petry, APRN, FNP-BC
• PH Pharmacy Inc.
• Sarah Phelan
• Nicole Philippou, CRPA-P
• Andrea M Phillips
• Lloyd Phillips, LCSW
• Mindy Phillips, PH.D.

• Psychiatric/Mental Health Nurse Practitioner in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.