Active NPI
Katherine Jackson, PH.D., ATR-BC
- Art Therapist
- Beachwood, OH
National Provider Identifier
1023754629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 90-057
- Practice address
- 23875 Commerce Park
Beachwood, OH 44122-5835 - Phone
- (216) 402-0336
- 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 |
|---|---|---|---|---|
| Art Therapist | 221700000X | 90-057 | OH | Primary |
Addresses
Primary practice location
23875 Commerce Park
Beachwood, OH 44122-5835
Mailing address
23875 Commerce Park
Beachwood, OH 44122-5835
Phone (216) 402-0336
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90-057 | OH | MD | Art Therapist |
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": "1651881600000",
"number": "1023754629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23875 COMMERCE PARK",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225835",
"telephone_number": "216-402-0336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23875 COMMERCE PARK",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225835",
"telephone_number": "216-402-0336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "PH.D., ATR-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-07",
"last_updated": "2022-05-07",
"certification_date": "2022-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "OH",
"license": "90-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.