Provider Demographics
NPI:1326558966
Name:GALARRITA, CRESA R (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:CRESA
Middle Name:R
Last Name:GALARRITA
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 BROADWAY STE 302
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5404
Mailing Address - Country:US
Mailing Address - Phone:347-453-0839
Mailing Address - Fax:
Practice Address - Street 1:1178 BROADWAY STE 302
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5404
Practice Address - Country:US
Practice Address - Phone:917-834-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007779-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health