Active NPI
Tiffany Marie Prather, PSYD
- Counseling Psychologist
- Wauwatosa, WI
National Provider Identifier
1003063090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 10045 W Lisbon Ave
Wauwatosa, WI 53222-2446 - Phone
- (414) 358-7999
- Fax
- (414) 358-7158
- NPI assigned
- Aug 21, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 13162-132 | WI | |
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
10045 W Lisbon Ave
Wauwatosa, WI 53222-2446
Mailing address
10045 W Lisbon Ave
Wauwatosa, WI 53222-2446
Phone (414) 358-7999
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 |
|---|---|---|---|
| 13162-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219276800000",
"number": "1003063090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10045 W LISBON AVE",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532222446",
"telephone_number": "414-358-7999",
"fax_number": "414-358-7158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10045 W LISBON AVE",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532222446",
"telephone_number": "414-358-7999",
"fax_number": "414-358-7158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATHER",
"first_name": "TIFFANY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-21",
"last_updated": "2008-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "13162-132",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.