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General NPI Number Information
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NPI Number | 1235731555
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Entity Type | Organization
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Legal Business Name | BENJAMIN DAVIS CREATIVE ARTS THERAPY PLLC
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 125 E 23RD ST STE 402
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City | NEW YORK
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State | NY
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Zip | 10010-4547
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Country | US
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Telephone | 917-476-0539
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Fax |
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Provider Business Mailing Address
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Address Line | 125 EAST 23RD STREET SUITE 402 #2
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City | NEW YORK
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State | NY
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Zip | 10010
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Country | US
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Telephone | 917-476-0539
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BENJAMIN DAVIS
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Credential | ATR-BC, LCAT
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Telephone | 917-476-0539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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