Mandala Psychological Services, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016210 Issued in NY

Legal business name

MANDALA PSYCHOLOGICAL SERVICES, P.C.

Practice address

2785 W 5TH St Apt 10E
Brooklyn, NY 11224-4612

Phone

(646) 415-1915

NPI assigned

Dec 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yelena Razdolskaya, PSY.DNPI 1396844924

Title

Psychologist

Phone

(646) 415-1915

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yelena Razdolskaya, PSY.D

  • Clinical Child & Adolescent Psychologist
  • Brooklyn, NY
  • NPI 1396844924
  Authorized official Same address or phone

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922164383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 W 5TH ST APT 10E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112244612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 W 5TH ST APT 10E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112244612",
            "telephone_number": "646-415-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDALA PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAZDOLSKAYA",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "646-415-1915",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02821658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene John Mancuso, MD
• Hamza Mancy
• Alex Benjamin Mand, D.P.M
• Michael J Mand, D.D.S.
• Yutika Mandal, MD
• Kathy Mandalaoui
• Nafisa Mandani, PSYD
• Behrooz Mandanipour, DPM
• Mandarino Chiropractic PC
• Aaron Mandel, OD

• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.