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General NPI Number Information
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NPI Number | 1881140432
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Entity Type | Organization
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Legal Business Name | MINDFUL MUSIC PSYCHOTHERAPY CREATIVE ARTS THERAPY, PLLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 424 CATON AVE
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City | BROOKLYN
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State | NY
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Zip | 11218
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Country | US
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Telephone | 917-518-1961
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Fax |
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Provider Business Mailing Address
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Address Line | 424 CATON AVE
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City | BROOKLYN
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State | NY
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Zip | 11218-1704
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Country | US
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Telephone | 917-518-1961
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KATIE DOWN
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Credential | MT-BC, LCAT
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Telephone | 917-426-4393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 001473-1
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License Number State | NY
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