Provider Demographics
NPI:1063273431
Name:ORLY BENDAVID CREATIVE ARTS THERAPY PLLC
Entity type:Organization
Organization Name:ORLY BENDAVID CREATIVE ARTS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-441-1777
Mailing Address - Street 1:192 GUERNSEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 S 5TH ST OFC EAST7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-5597
Practice Address - Country:US
Practice Address - Phone:818-441-1777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty