Provider Demographics
NPI:1184044638
Name:CAREN SACKS MA, ATR-BC, LCAT, PLLC
Entity Type:Organization
Organization Name:CAREN SACKS MA, ATR-BC, LCAT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ART PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, LCAT, AT
Authorized Official - Phone:914-698-6436
Mailing Address - Street 1:174 E BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3701
Mailing Address - Country:US
Mailing Address - Phone:914-698-6436
Mailing Address - Fax:
Practice Address - Street 1:174 E BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3701
Practice Address - Country:US
Practice Address - Phone:914-698-6436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000319221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty