Healthcare Provider Details

I. General information

NPI: 1326969346
Provider Name (Legal Business Name): SIVESIND PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 JAVA ST STE 323
BROOKLYN NY
11222-5558
US

IV. Provider business mailing address

252 JAVA ST STE 323
BROOKLYN NY
11222-5558
US

V. Phone/Fax

Practice location:
  • Phone: 917-627-1014
  • Fax:
Mailing address:
  • Phone: 917-627-1014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DAVID SIVESIND
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 917-627-1014