Healthcare Provider Details
I. General information
NPI: 1306513833
Provider Name (Legal Business Name): WORK OF ART ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
81 N SAN MARINO AVE STE 2
PASADENA CA
91107-3535
US
IV. Provider business mailing address
81 N SAN MARINO AVE STE 2
PASADENA CA
91107-3535
US
V. Phone/Fax
- Phone: 562-212-0095
- Fax:
- Phone: 562-212-0095
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
R
THOMAS
Title or Position: CEO/PRESIDENT
Credential: MS
Phone: 562-212-0095