Healthcare Provider Details

I. General information

NPI: 1003474669
Provider Name (Legal Business Name): TATYANA KRYCHKINA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TATYANA MUCCI, ECCLESTON, MEDITSEVA LCSW

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE ECHO HILLS CORDERO BLD., SUITE 131 C
DOBBS FERRY NY
10522
US

IV. Provider business mailing address

4A ADRIAN CT
CORTLANDT MANOR NY
10567-4145
US

V. Phone/Fax

Practice location:
  • Phone: 914-693-0600
  • Fax:
Mailing address:
  • Phone: 917-596-0127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102157-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: