Vivid Minds, LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

VIVID MINDS, LLC

Practice address

37 Conger St
Staten Island, NY 10305-4505

Phone

(347) 575-7997

Fax

(718) 368-0508

NPI assigned

Jul 13, 2016

Organization subpart

No

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

Authorized official

Name

Kateryna SternNPI 1235491937

Title

Ceo

Phone

(347) 575-7997

Specialties & licenses 2

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kateryna Stern

  • Specialist
  • Brooklyn, NY
  • NPI 1235491937
  NPD Authorized official
• Anastasia V Novikova

  • Specialist
  • Brooklyn, NY
  • NPI 1457028383
  NPD (past)

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1720430838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CONGER ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054505",
            "telephone_number": "347-575-7997",
            "fax_number": "718-368-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CONGER ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054505",
            "telephone_number": "347-575-7997",
            "fax_number": "718-368-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID MINDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "KATERYNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-575-7997"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carianne Vivaldi, M.A. CCC-SLP
• Abhirami Vivekanandarajah, M.D.
• Adrienne M. Viviano, P.A.
• Arlene Viviano, RN
• Vivid Imagination Station LLC
• Vladimir Fedosseev Physical Therapy PC
• Nicholas Vlassenko, PT
• Margarita Vodopyanov, LMSW
• Brielle Vodovoz, R.N.
• Jeanette Voice, MD

• Early Intervention Provider Agency in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.