Healthcare Provider Details
I. General information
NPI: 1275815276
Provider Name (Legal Business Name): ORLY SARAH BENDAVID MA, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/15/2011
Last Update Date: 08/10/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
192 GUERNSEY ST APARTMENT 2
BROOKLYN NY
11222-2693
US
IV. Provider business mailing address
192 GUERNSEY ST APARTMENT 2
BROOKLYN NY
11222-2693
US
V. Phone/Fax
- Phone: 818-441-1777
- Fax:
- Phone: 818-441-1777
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 01666 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: