Organization Active NPI

Kids Play Therapy LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Goshen, NY
National Provider Identifier
1770732158
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
008688-1 Issued in NY
Legal business name
KIDS PLAY THERAPY LLC
Practice address
209 Murray Ave
Goshen, NY 10924-1205
Phone
(917) 822-6461
NPI assigned
Sep 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Authorized official

Name
Xeriss Joanah Santa Ana, OTR/L
Title
Occupational Therapist
Phone
(917) 822-6461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 008688-1 NY Primary

Addresses

Primary practice location

209 Murray Ave
Goshen, NY 10924-1205

Mailing address

209 Murray Ave
Goshen, NY 10924-1205
Phone (917) 822-6461

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1770732158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MURRAY AVE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241205",
            "telephone_number": "917-822-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MURRAY AVE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241205",
            "telephone_number": "917-822-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS PLAY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "SANTA ANA",
        "authorized_official_first_name": "XERISS",
        "authorized_official_middle_name": "JOANAH",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "917-822-6461",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": "008688-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.