Provider Demographics
NPI:1982345385
Name:EMBODIED CREATIVE ARTS THERAPY PLLC
Entity type:Organization
Organization Name:EMBODIED CREATIVE ARTS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:LCAT
Authorized Official - Phone:914-257-3732
Mailing Address - Street 1:1858 PLEASANTVILLE RD STE 121
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1025
Mailing Address - Country:US
Mailing Address - Phone:914-257-3732
Mailing Address - Fax:
Practice Address - Street 1:112 W 27TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6241
Practice Address - Country:US
Practice Address - Phone:914-257-3732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1851921084OtherNPPES