Provider Demographics
NPI:1528635661
Name:START: CREATIVE ARTS THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:START: CREATIVE ARTS THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUND AND DIRECTOR / THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:ATR-BC, LCAT
Authorized Official - Phone:631-867-2501
Mailing Address - Street 1:1527 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-4541
Mailing Address - Country:US
Mailing Address - Phone:631-662-4141
Mailing Address - Fax:
Practice Address - Street 1:1527 5TH ST
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-4541
Practice Address - Country:US
Practice Address - Phone:631-662-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty