Individual provider Active NPI

Tatyana Shchupak, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1720343643
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022069 Issued in NY
Practice address
1866 W 5TH St
Brooklyn, NY 11223-2638
Phone
(347) 542-0711
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 022069 NY Primary

Addresses

Primary practice location

1866 W 5TH St
Brooklyn, NY 11223-2638

Mailing address

1866 W 5TH St
Brooklyn, NY 11223-2638
Phone (347) 542-0711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
022069NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
TS Psychological Services PLLC Clinical CurrentSince Feb 2, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1720343643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 W 5TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232638",
            "telephone_number": "347-542-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 W 5TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232638",
            "telephone_number": "347-542-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHCHUPAK",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.