Active NPI
Alicia Ballestas, LCAT, ATR-BC
- Art Therapist
- Brooklyn, NY
National Provider Identifier
1558759753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 001796-1
- Practice address
- 315 Wyckoff Ave
6TH Floor
Brooklyn, NY 11237-5384 - Phone
- (718) 497-6090
- NPI assigned
- Dec 23, 2014
- Last updated
- Dec 23, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 001796-1 | NY | Primary |
Addresses
Primary practice location
315 Wyckoff Ave
6TH Floor
Brooklyn, NY 11237-5384
Mailing address
15348 78TH Rd
3Rd Floor
Flushing, NY 11367-3542
Phone (954) 825-6319
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 |
|---|---|---|---|
| 001796-1 | NY | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419292800000",
"number": "1558759753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15348 78TH RD",
"address_2": "3RD FLOOR",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673542",
"telephone_number": "954-825-6319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 WYCKOFF AVE",
"address_2": "6TH FLOOR",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112375384",
"telephone_number": "718-497-6090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLESTAS",
"first_name": "ALICIA",
"name_prefix": "Miss",
"credential": "LCAT, ATR-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-23",
"last_updated": "2014-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": "001796-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.