Provider Demographics
NPI:1275815276
Name:BENDAVID, ORLY SARAH (MA, MT-BC)
Entity Type:Individual
Prefix:MISS
First Name:ORLY
Middle Name:SARAH
Last Name:BENDAVID
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 GUERNSEY ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2693
Mailing Address - Country:US
Mailing Address - Phone:818-441-1777
Mailing Address - Fax:
Practice Address - Street 1:192 GUERNSEY ST
Practice Address - Street 2:APARTMENT 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2693
Practice Address - Country:US
Practice Address - Phone:818-441-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225A00000X
NY01666101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist