Active NPIIndividual providerSole proprietor

Dr. Mindy S Kopolow, MA, PSYD

Psychologist, Clinical in Woburn, Massachusetts

NPI Number1053583120
Practice location
400 W Cummings Park, Suite 3400, Woburn, MA 01801-6519
Fax
617-972-5011
Last updated
April 4, 2013

Mindy Sue Kopolow is a Psychologist, Clinical based in Woburn, MA. Mindy Sue Kopolow practices in Woburn, MA and has the professional credentials of MA, PSYD. The NPI Number for Mindy Sue Kopolow is 1053583120 and holds a License No. 851 (MA). The current practice location address for Mindy Sue Kopolow is 400 W Cummings Park, Suite 3400, Woburn, MA 01801-6519 and can be reached out via phone at 617-972-5055 and via fax at 617-972-5011.

Provider Profile Details

NPI Number
1053583120
Provider Name
Mindy Sue Kopolow
Credential
MA, PSYD
Provider Entity Type
Individual
Gender
Female
Address
400 W Cummings Park, Suite 3400, Woburn, MA 01801-6519
Phone Number
617-972-5055
Fax Number
617-972-5011
Primary Taxonomy
Psychologist, Clinical · 103TC0700X
Sole Proprietor
Yes
Provider Enumeration Date
March 29, 2008
Last Update Date
April 4, 2013
NPI Status
Active

Provider Business Practice Location Address Details

Address
400 W Cummings Park
Suite 3400
Woburn, MA 01801-6519
City
Woburn
Zip
01801-6519
Phone Number
617-972-5055
Fax Number
617-972-5011
Woburn, MA 01801Get directions →

Provider Business Mailing Address Details

Address
400 W Cummings Park
Suite 3400
Woburn, MA 01801-6519
City
Woburn
State
MA
Zip
01801-6519
Phone Number
617-972-5055
Fax Number
617-972-5011

License Information

License Number (1)
851
License State (1)
MA
Taxonomy (1)
Counselor, Mental Health · 101YM0800X
License Number (2)
8603
License State (2)
MA
Taxonomy (2)
Psychologist, Clinical · 103TC0700X · Primary
License Number (3)
PY5819
License State (3)
FL
Taxonomy (3)
Psychologist, Clinical · 103TC0700X

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Dr. Mindy S Kopolow, MA, PSYD?

The NPI number of Dr. Mindy S Kopolow, MA, PSYD is 1053583120. It was assigned on March 29, 2008 and is currently active in the NPPES registry.

What is the specialty of Dr. Mindy S Kopolow, MA, PSYD?

Dr. Mindy S Kopolow, MA, PSYD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in MA under license number 851.

Where does Dr. Mindy S Kopolow, MA, PSYD practice?

The practice location is 400 W Cummings Park, Suite 3400, Woburn, MA 01801-6519. The office can be reached at 617-972-5055 (phone) or 617-972-5011 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1053583120 directly on the NPPES registry website.

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