Individual provider Active NPI

Katrina L Carroll-Haskins

  • Art Therapist
  • Philadelphia, PA
National Provider Identifier
1164124558
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
20-185 Issued in PA
Practice address
2517 W Girard Ave
Philadelphia, PA 19130-1313
Phone
(267) 306-1327
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 20-185 PA Primary

Addresses

Primary practice location

2517 W Girard Ave
Philadelphia, PA 19130-1313

Mailing address

512 Arthur St
Philadelphia, PA 19111-2351

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
20-185PAMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1164124558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 ARTHUR ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301313",
            "telephone_number": "267-306-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL-HASKINS",
        "first_name": "KATRINA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "PA",
            "license": "20-185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.