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DR. MINDY SUE KOPOLOW M.A., PSY.D.
NPI 1053583120
Psychologist - Clinical in Woburn, MA

Active since March 29, 2008Opted out of Medicare · through Dec 5, 2026
400 W CUMMINGS PARK, SUITE 3400, WOBURN, MA 01801(617) 972-5055(617) 972-5011 Get Directions Write a Review

NPPES record last updated: April 4, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mindy Sue Kopolow M.a., Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MINDY SUE KOPOLOW M.A., PSY.D. (NPI 1053583120) is an individual clinical provider in Woburn, Massachusetts, licensed in Massachusetts (8603) and active in the NPI registry since March 2008. She has opted out of Medicare through December 5, 2026.

NPPES Registry Identity

NPI1053583120
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MINDY SUE KOPOLOWCredential: M.A., PSY.D.
Location Address400 W CUMMINGS PARK, SUITE 3400Woburn, MA 01801-6519
Mailing Address400 W Cummings Park, Suite 3400Woburn, MA 01801-6519 · (617) 972-5055 · Fax (617) 972-5011
Phone(617) 972-5055
Fax(617) 972-5011
Sole ProprietorYes
Enumeration DateMarch 29, 2008
Last NPPES UpdateApril 4, 2013
✔ NPI 1053583120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in MA · 8603✔ Licensed in FL · PY5819
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 851 (MA)
400 W CUMMINGS PARK, Woburn, MA 01801
Open in Google Maps ↗

Other Identifiers 2

Other54439FL · Bcbs Of Florida
Medicare PIN54439FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Mindy Sue Kopolow M.a., Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 5, 2022 through December 5, 2026.

Opt-Out Effective DateDecember 5, 2022
Opt-Out In Effect ThroughDecember 5, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICIA DEMARTINO PTA
Physical Therapy Assistant
400 W CUMMINGS PARK, SUITE 3950
WOBURN, MA 01801
Middlesex County (781) 933-8800
THERESA BERGAMI PTA
Physical Therapy Assistant
400 W CUMMINGS PARK
WOBURN, MA 01801
Middlesex County (781) 933-8800
SHANNON CHEEVER-LECLAIR COTA
Occupational Therapy Assistant
400 W CUMMINGS PARK
WOBURN, MA 01801
Middlesex County (781) 933-8800
LAURA BLOCK PTA
Physical Therapy Assistant
400 W CUMMINGS PARK, SUITE 3950
WOBURN, MA 01801
Middlesex County (781) 933-8800
KIMBERLY SARNACKI PT
Physical Therapist
400 W CUMMINGS PARK
WOBURN, MA 01801
Middlesex County (781) 933-8800
MRS. GRACE PETRONELLA OTR
Occupational Therapist
400 W CUMMINGS PARK, SUITE 3950
WOBURN, MA 01801
Middlesex County (800) 451-9101
KRISTEN VANDER PLAAT OT
Occupational Therapist
400 W CUMMINGS PARK
WOBURN, MA 01801
Middlesex County (781) 933-8800
REBECCA LYNN BONAGURA OTR
Occupational Therapist
400 W CUMMINGS PARK, SUITE3950
WOBURN, MA 01801
Middlesex County (800) 451-9101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mindy Kopolow's NPI number?

The NPI number for Mindy Kopolow is 1053583120. It was assigned to this individual provider in the NPPES registry on March 29, 2008.

Where is Mindy Kopolow located?

Mindy Kopolow practices at 400 W Cummings Park Suite 3400, Woburn, MA 01801. The listed phone number is (617) 972-5055.

What is Mindy Kopolow's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mindy Kopolow enrolled in Medicare?

No. Mindy Kopolow has opted out of Medicare through December 5, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Mindy Kopolow accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Mindy Kopolow as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mindy Kopolow was last updated on April 4, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.