Provider Demographics
NPI:1710770680
Name:YOUNG, ELLA
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3111
Mailing Address - Country:US
Mailing Address - Phone:914-625-1637
Mailing Address - Fax:866-820-8106
Practice Address - Street 1:3008 ISLAND DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3111
Practice Address - Country:US
Practice Address - Phone:914-625-1637
Practice Address - Fax:866-820-8106
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician