# BEAUREGARD CREATIVE ARTS THERAPY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093572679
- **Authorized official:** MARK BEAUREGARD RDT/BCT, LCAT (FOUNDER/SOLE MEMBER)
- **Authorized official phone:** (917) 204-2846

## Contact information

- **Practice address:** 225 BROADWAY STE 2130, NEW YORK, NY 10007-3733
- **Practice address phone:** (917) 204-2846
- **Mailing address:** 135 COFFEY ST APT 206C, BROOKLYN, NY 11231-1055
- **Mailing address phone:** (917) 204-2846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101200000X | Drama Therapist | — | NULL | Yes |
| 101200000X | Drama Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/29/2024
- **Last updated:** 02/29/2024