Healthcare Provider Details

I. General information

NPI: 1487542502
Provider Name (Legal Business Name): NATALIA POPOVA MHC-LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 MAIN ST
STATEN ISLAND NY
10307-1261
US

IV. Provider business mailing address

675 W 59TH ST APT 509
NEW YORK NY
10019-1304
US

V. Phone/Fax

Practice location:
  • Phone: 347-733-9964
  • Fax:
Mailing address:
  • Phone: 347-604-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: