Anastacia Y. Kudinova

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PS02153 Issued in RI

Practice address

1 Hoppin St
Providence, RI 02903-4141

Phone

(401) 444-8945

Fax

(401) 444-8742

NPI assigned

May 24, 2024

Last updated

Jun 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1316786668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141",
            "telephone_number": "401-444-8945",
            "fax_number": "401-444-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDINOVA",
        "first_name": "ANASTACIA",
        "middle_name": "Y.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02153",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "RI",
            "license": "PS02153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Krupowies, LMHC
• Andreas Olof Kruse, MD
• Alyssa Krysko, AUD
• Magdalena G Krzystolik, MD
• Halina Kuc-Mazgaj
• Taylor Kue, PA
• Regina Leigh Kuecks-Morgan, PH.D.
• Francis Ruth Kuehnle, RN
• Amanda M Kugler, MSCCC-SLP
• Anne Kugler, LICSW, LP

• Clinical Child & Adolescent Psychologist in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Child & Adolescent Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.