NPIMap

Organization Active NPI

New York Creative Arts Therapists PLLC

  • Art Therapist
  • Brooklyn, NY
National Provider Identifier
1578899415
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
000250 Issued in NY
Legal business name
NEW YORK CREATIVE ARTS THERAPISTS PLLC
Practice address
190 N 10TH St
Suite 301
Brooklyn, NY 11211-9317
Phone
(917) 293-4642
NPI assigned
Oct 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Drena Fagen, LCAT, LCSW-RNPI 1033276001
Title
Director
Phone
(917) 293-4642

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 077035 NY
Art TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 221700000X 0000144 NY
Art TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 221700000X 000250 NY Primary

Addresses

Primary practice location

190 N 10TH St
Suite 301
Brooklyn, NY 11211-9317

Mailing address

190 N 10TH St
Suite 301
Brooklyn, NY 11211-9317
Phone (917) 293-4642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120113000209 NY Part B Supplier - Clinic/Group Practice 1456528512 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

190 N 10th St
Ste 301
Brooklyn, NY 11211
Phone (917) 293-4642

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1578899415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N 10TH ST",
            "address_2": "SUITE 301",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112119317",
            "telephone_number": "917-293-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N 10TH ST",
            "address_2": "SUITE 301",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112119317",
            "telephone_number": "917-293-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK CREATIVE ARTS THERAPISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "FAGEN",
        "authorized_official_first_name": "DRENA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-293-4642",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCAT, LCSW-R"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "077035",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "0000144",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "000250",
            "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 Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.