Kopolow, Mindy Sue

Kopolow, Mindy Sue is an sole proprietor health care provider with primary practice located at 400 W Cummings Park Suite 3400, Woburn MA 01801-6519. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kopolow, Mindy Sue can be contacted via phone (617) 972-5055.

Contact Information

Primary practice address
400 W Cummings Park Suite 3400 Woburn MA 01801-6519
Phone: (617) 972-5055
Fax: (617) 972-5011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 851 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 8603 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY5819 Florida

Profile Details

NPI number 1053583120
LBN Legal business name Kopolow, Mindy Sue
Credentials M.A., PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2008
Last updated Apr 4th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053583120 NPPES
Florida Other 54439 BCBS OF FLORIDA

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