Provider Demographics
NPI:1720672413
Name:CENTER FOR THERAPEUTIC ARTS
Entity Type:Organization
Organization Name:CENTER FOR THERAPEUTIC ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINTAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LPC, ATR
Authorized Official - Phone:248-200-9962
Mailing Address - Street 1:2425 DALLAS AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3584
Mailing Address - Country:US
Mailing Address - Phone:248-200-9962
Mailing Address - Fax:
Practice Address - Street 1:376 HILTON RD APT B
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2956
Practice Address - Country:US
Practice Address - Phone:248-200-9962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty