Provider Demographics
NPI:1578022372
Name:ART WITH SAMANTHA: CREATIVE ART THERAPY SERVICES, P.C.
Entity Type:Organization
Organization Name:ART WITH SAMANTHA: CREATIVE ART THERAPY SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ART THERAPIST/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, LCAT
Authorized Official - Phone:631-229-7832
Mailing Address - Street 1:21 PULASKI RD STE 103
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-2530
Mailing Address - Country:US
Mailing Address - Phone:631-229-7832
Mailing Address - Fax:
Practice Address - Street 1:517 LARKFIELD RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4208
Practice Address - Country:US
Practice Address - Phone:631-229-7832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health