| New York Creative Arts Therapists Pllc | |
|
190 N 10th St Suite 301 Brooklyn NY 11211-9317 | |
| (917) 293-4642 | |
| Not Available |
| Full Name | New York Creative Arts Therapists Pllc |
|---|---|
| Speciality | Art Therapist |
| Location | 190 N 10th St, Brooklyn, New York |
| Authorized Official Name and Position | Drena Fagen (DIRECTOR) |
| Authorized Official Contact | 9172934642 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New York Creative Arts Therapists Pllc 190 N 10th St Suite 301 Brooklyn NY 11211-9317 Ph: (917) 293-4642 | New York Creative Arts Therapists Pllc 190 N 10th St Suite 301 Brooklyn NY 11211-9317 Ph: (917) 293-4642 |
| NPI Number | 1578899415 |
|---|---|
| Provider Enumeration Date | 10/28/2009 |
| Last Update Date | 08/08/2017 |
| Medicare PECOS PAC ID | 1456528512 |
|---|---|
| Medicare Enrollment ID | O20120113000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578899415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 077035 (New York) | Secondary |
| 221700000X | Art Therapist | 0000144 (New York) | Secondary |
| 221700000X | Art Therapist | 000250 (New York) | Primary |
| Provider Name | Drena Fagen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033276001 PECOS PAC ID: 2264609320 Enrollment ID: I20120113000280 |
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