Provider Demographics
NPI:1811381668
Name:MA THERAPY
Entity type:Organization
Organization Name:MA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMIRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARTIN-SALTSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:646-662-4049
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:ALMOND
Mailing Address - State:NY
Mailing Address - Zip Code:14804-0055
Mailing Address - Country:US
Mailing Address - Phone:646-662-4049
Mailing Address - Fax:
Practice Address - Street 1:303 SENECA RD STE C
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1000
Practice Address - Country:US
Practice Address - Phone:646-662-4049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0761391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty