Healthcare Provider Details

I. General information

NPI: 1679491039
Provider Name (Legal Business Name): MIND BRIDGES PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 COURT ST STE 704
BROOKLYN NY
11242-1107
US

IV. Provider business mailing address

26 COURT ST STE 704
BROOKLYN NY
11242-1107
US

V. Phone/Fax

Practice location:
  • Phone: 646-504-4564
  • Fax:
Mailing address:
  • Phone: 646-504-4564
  • 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: NADIA KUPRIAN
Title or Position: CLINICAL DIRECTOR
Credential: PHD PSYCHOLOGIST
Phone: 646-509-0240