Provider Demographics
NPI:1063656379
Name:BRINDLE, KYANA (MA)
Entity Type:Individual
Prefix:
First Name:KYANA
Middle Name:
Last Name:BRINDLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 112TH ST
Mailing Address - Street 2:APT 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3528
Mailing Address - Country:US
Mailing Address - Phone:917-743-3321
Mailing Address - Fax:
Practice Address - Street 1:1 HOYT ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5809
Practice Address - Country:US
Practice Address - Phone:718-578-9813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health