Provider Demographics
NPI:1861703175
Name:YOUNG SORBELLO, JESSICA L (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:YOUNG SORBELLO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 NY 2
Mailing Address - Street 2:
Mailing Address - City:CROPSEYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12052
Mailing Address - Country:US
Mailing Address - Phone:518-452-6737
Mailing Address - Fax:518-452-6756
Practice Address - Street 1:7 GIFFORD LN
Practice Address - Street 2:
Practice Address - City:MEDUSA
Practice Address - State:NY
Practice Address - Zip Code:12120-1823
Practice Address - Country:US
Practice Address - Phone:518-452-6709
Practice Address - Fax:518-452-6756
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)