Provider Demographics
NPI:1619322914
Name:NEW PALTZ CREATIVE ARTS THERAPY FOR TRAUMA PLLC
Entity Type:Organization
Organization Name:NEW PALTZ CREATIVE ARTS THERAPY FOR TRAUMA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPS LCAT
Authorized Official - Phone:845-417-8301
Mailing Address - Street 1:474 STATE ROUTE 32 N
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3040
Mailing Address - Country:US
Mailing Address - Phone:845-417-8301
Mailing Address - Fax:
Practice Address - Street 1:474 STATE ROUTE 32 N
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3040
Practice Address - Country:US
Practice Address - Phone:845-417-8301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001667221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty