Provider Demographics
NPI:1346317468
Name:ARISTA CENTER FOR PSYCHOTHERAPY INC
Entity Type:Organization
Organization Name:ARISTA CENTER FOR PSYCHOTHERAPY INC
Other - Org Name:ARISTA CENTER FOR PSYCHOTHERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PREISS-LOWENWIRT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-793-3133
Mailing Address - Street 1:110 20 71 RD
Mailing Address - Street 2:111
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-793-3133
Mailing Address - Fax:718-793-2023
Practice Address - Street 1:110 20 71 RD
Practice Address - Street 2:111
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-793-3133
Practice Address - Fax:718-793-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY6741100A261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244826Medicaid
=========OtherINSURANCE COMPANY