Provider Demographics
NPI:1881140432
Name:MINDFUL MUSIC PSYCHOTHERAPY CREATIVE ARTS THERAPY, PLLC
Entity type:Organization
Organization Name:MINDFUL MUSIC PSYCHOTHERAPY CREATIVE ARTS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWN
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC, LCAT
Authorized Official - Phone:917-426-4393
Mailing Address - Street 1:424 CATON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1704
Mailing Address - Country:US
Mailing Address - Phone:917-518-1961
Mailing Address - Fax:
Practice Address - Street 1:424 CATON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:917-518-1961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001473-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty