Healthcare Provider Details

I. General information

NPI: 1396409348
Provider Name (Legal Business Name): CREATIVE ARTS THERAPY OF ROCKLAND, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N MIDDLETOWN RD STE 1D
PEARL RIVER NY
10965-1189
US

IV. Provider business mailing address

83 BRAUNSDORF RD
PEARL RIVER NY
10965-1814
US

V. Phone/Fax

Practice location:
  • Phone: 845-641-8232
  • Fax:
Mailing address:
  • Phone: 845-641-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA GREGO
Title or Position: OWNER
Credential: LCAT
Phone: 845-641-8232