Active NPI
Ceyli Jackson
- Drama Therapist
- Austin, TX
National Provider Identifier
1003552696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Drama Therapist
- Practice address
- 5100 Pecan Brook Dr
Austin, TX 78724-3302 - Phone
- (512) 537-1957
- NPI assigned
- May 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Drama Therapist | 101200000X | Primary |
Addresses
Primary practice location
5100 Pecan Brook Dr
Austin, TX 78724-3302
Mailing address
PO Box 113
Manor, TX 78653-0113
Phone (512) 537-1957
Other practice location 1
6510 Carisbrooke Ln
Austin, TX 78754-5700
Phone (512) 569-8089
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1003552696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 113",
"city": "MANOR",
"state": "TX",
"postal_code": "786530113",
"telephone_number": "512-537-1957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 PECAN BROOK DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787243302",
"telephone_number": "512-537-1957"
}
],
"practiceLocations": [
{
"address_1": "6510 Carisbrooke Ln",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787545700",
"country_code": "US",
"telephone_number": "512-569-8089",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "CEYLI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-07",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101200000X",
"taxonomy_group": "",
"desc": "Drama Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.