MEDICARE: HAVEN WITHIN CREATIVE ARTS THERAPY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist

General Provider Information

NPI Number	:	1417802851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN WITHIN CREATIVE ARTS THERAPY PLLC

Provider Business Mailing Address
First Line	:	23 W SALTAIRE RD
Second Line	:
City	:	LINDENHURST
State	:	NY
Zip	:	11757-6635
Country	:	US
Telephone Number	:	516-468-5980
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 W SALTAIRE RD
Second Line	:
City	:	LINDENHURST
State	:	NY
Zip	:	11757-6635
Country	:	US
Telephone Number	:	516-468-5980
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JILLIAN MARTINO
Credential	:	LCAT
Telephone Number	:	516-468-5980

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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