Provider Demographics
NPI:1811574650
Name:ART AS THERAPY & TRAUMA SOLUTIONS LLC
Entity Type:Organization
Organization Name:ART AS THERAPY & TRAUMA SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PHOEBE
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC ATR
Authorized Official - Phone:541-203-0970
Mailing Address - Street 1:66975 WEST ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-9283
Mailing Address - Country:US
Mailing Address - Phone:541-203-0970
Mailing Address - Fax:
Practice Address - Street 1:66975 WEST ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-9283
Practice Address - Country:US
Practice Address - Phone:541-203-0970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty