Active NPI
Patricia Mary Slack, ATR-BC, LCAT, CASAC
- Art Therapist
- North Syracuse, NY
National Provider Identifier
1477694479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- ATR-BC 92-321
- Practice address
- 116 Primrose LN
North Syracuse, NY 13212-4230 - Phone
- (315) 457-2107
- NPI assigned
- Feb 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | ATR-BC 92-321 | NY | Primary |
Addresses
Primary practice location
116 Primrose LN
North Syracuse, NY 13212-4230
Mailing address
116 Primrose LN
North Syracuse, NY 13212-4230
Phone (315) 457-2107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATR-BC 92-321 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477694479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 PRIMROSE LN",
"city": "NORTH SYRACUSE",
"state": "NY",
"postal_code": "132124230",
"telephone_number": "315-457-2107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 PRIMROSE LN",
"city": "NORTH SYRACUSE",
"state": "NY",
"postal_code": "132124230",
"telephone_number": "315-457-2107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLACK",
"first_name": "PATRICIA",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "ATR-BC, LCAT, CASAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": "ATR-BC 92-321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.