Provider Demographics
NPI:1659043206
Name:MOVEMENT FOR THE MIND CREATIVE ARTS THERAPY PLLC
Entity Type:Organization
Organization Name:MOVEMENT FOR THE MIND CREATIVE ARTS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:UNADKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCAT, LMHC
Authorized Official - Phone:607-425-3848
Mailing Address - Street 1:2638 21ST ST APT 14A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4204
Mailing Address - Country:US
Mailing Address - Phone:607-425-3848
Mailing Address - Fax:
Practice Address - Street 1:2638 21ST ST APT 14A
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-4204
Practice Address - Country:US
Practice Address - Phone:607-425-3848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty