MEDICARE: SMALL STEPS PSYCHOLOGY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1659985083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMALL STEPS PSYCHOLOGY PLLC

Provider Business Mailing Address
First Line	:	247 57TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3308
Country	:	US
Telephone Number	:	929-265-0308
Fax Number	:

Provider Business Practice Location Address
First Line	:	247 57TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3308
Country	:	US
Telephone Number	:	929-265-0308
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. LINDA KUDLA
Credential	:	PSY.D.
Telephone Number	:	929-265-0308

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	09/02/2020

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