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General NPI Number Information
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NPI Number | 1578180410
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Entity Type | Organization
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Legal Business Name | MANHATTAN PLAY THERAPY LCSW PLLC
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 1115 BROADWAY FL 12
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City | NEW YORK
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State | NY
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Zip | 10010-3452
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Country | US
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Telephone | 646-926-1187
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 BROADWAY FL 12
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City | NEW YORK
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State | NY
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Zip | 10010-3452
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST, PRACTICE OWNER
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Name | KRISTIN PLEINES
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Credential | LCSW, DSW
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Telephone | 203-906-3085
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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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Taxonomy #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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