Individual provider · NPI-1
Staci Abby, LCAT
Drama Therapist · Astoria, NY
NPI number1275259665
StatusActive
Last updated in NPPESJul 17, 2024
Details
- NPI
- 1275259665
- Entity type
- Individual (NPI-1)
- Name
- Staci Abby
- Credential
- LCAT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 17, 2022
- Certification date
- Jul 17, 2024
- Last updated
- Jul 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101200000X | Drama Therapist | 002410-01 | NY | Yes |
| 101Y00000X | Counselor | 002410 | NY |
Other names
- Staci Jacobson (Former Name)
Practice location
2503 32nd StAstoria, NY 11102-5011
Phone 205-639-9304
Mailing address
2503 32nd StAstoria, NY 11102-5011
Phone 205-639-9304
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