Provider Demographics
NPI:1922480094
Name:WHOLEHEARTED CREATIVE ARTS THERAPY PLLC
Entity Type:Organization
Organization Name:WHOLEHEARTED CREATIVE ARTS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CREATIVE ARTS THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAKAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCAT
Authorized Official - Phone:917-392-1134
Mailing Address - Street 1:501 E BOSTON POST RD STE 2
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3761
Mailing Address - Country:US
Mailing Address - Phone:917-392-1134
Mailing Address - Fax:
Practice Address - Street 1:501 E BOSTON POST RD STE 2
Practice Address - Street 2:SUITE # 3
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3761
Practice Address - Country:US
Practice Address - Phone:917-392-1134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001873221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty