Individual provider Active NPI

Shirley Jean Young, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Leavenworth, KS
National Provider Identifier
1619661857
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023031138 Issued in MO
Practice address
4101 S 4TH St
Leavenworth, KS 66048-5014
Phone
(913) 682-2000
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023031138 MO Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 53-82333-051 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5382333051 KS

Addresses

Primary practice location

4101 S 4TH St
Leavenworth, KS 66048-5014

Mailing address

4101 S 4TH St
Leavenworth, KS 66048-5014
Phone (913) 682-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-82333-051KSMDPsychiatric/Mental Health Registered Nurse
5382333051KSMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1619661857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485014",
            "telephone_number": "913-682-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485014",
            "telephone_number": "913-682-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SHIRLEY",
        "middle_name": "JEAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023031138",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-82333-051",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "5382333051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.