Healthcare Provider Details

I. General information

NPI: 1790650083
Provider Name (Legal Business Name): ART THERAPY FOR ALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6919 N FIGUEROA ST
LOS ANGELES CA
90042-1245
US

IV. Provider business mailing address

6919 N FIGUEROA ST
LOS ANGELES CA
90042-1245
US

V. Phone/Fax

Practice location:
  • Phone: 503-926-0081
  • Fax:
Mailing address:
  • Phone: 503-926-0081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA L MINCKLEY
Title or Position: EXECUTIVE DIRECTOR
Credential: LMHC ATR-BC
Phone: 503-926-0081