Provider Demographics
NPI:1932975455
Name:ELIZABETH SMITH CREATIVE ARTS THERAPY
Entity type:Organization
Organization Name:ELIZABETH SMITH CREATIVE ARTS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCAT, ATR-BC, CCLS
Authorized Official - Phone:551-697-3522
Mailing Address - Street 1:1130 BEDFORD AVE # 1002
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1303
Mailing Address - Country:US
Mailing Address - Phone:551-697-3522
Mailing Address - Fax:
Practice Address - Street 1:1032 BERGEN ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3340
Practice Address - Country:US
Practice Address - Phone:551-697-3522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty