Individual provider Active NPI

Jennie Hawkes Tilton, MARRIAGE AND FAMILY

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1093526246
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MI4459 Issued in NV
Practice address
2445 Fire Mesa St Ste 190
Las Vegas, NV 89128-9015
Phone
(702) 456-4262
NPI assigned
Jan 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MI4459 NV Primary

Addresses

Primary practice location

2445 Fire Mesa St Ste 190
Las Vegas, NV 89128-9015

Mailing address

2445 Fire Mesa St Ste 190
Las Vegas, NV 89128-9015

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

LicenseStateTypeSpecialty
MI4459NVMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1093526246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 FIRE MESA ST STE 190",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 FIRE MESA ST STE 190",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289015",
            "telephone_number": "702-456-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "JENNIE",
        "middle_name": "HAWKES",
        "credential": "MARRIAGE AND FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI4459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.