Active NPI
Hayley Susanne Park, MT-BC
- Music Therapist
- Prescott, AZ
National Provider Identifier
1336798172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 13584
- Practice address
- 500 N US Highway 89 BLDG 148
Prescott, AZ 86313-5001 - Phone
- (928) 445-4860
- NPI assigned
- Sep 4, 2019
- Reactivated
- Nov 18, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 13584 | AZ | Primary |
Addresses
Primary practice location
500 N US Highway 89 BLDG 148
Prescott, AZ 86313-5001
Mailing address
500 N US Highway 89 BLDG 148
Prescott, AZ 86313-5001
Phone (928) 445-4860
Other practice location 1
300 S McCormick St
Prescott, AZ 86303-4254
Phone (760) 662-3933
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 |
|---|---|---|---|
| 13584 | AZ | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1336798172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N US HIGHWAY 89 BLDG 148",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863135001",
"telephone_number": "928-445-4860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N US HIGHWAY 89 BLDG 148",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863135001",
"telephone_number": "928-445-4860"
}
],
"practiceLocations": [
{
"address_1": "300 S McCormick St",
"address_purpose": "LOCATION",
"city": "Prescott",
"state": "AZ",
"postal_code": "863034254",
"country_code": "US",
"telephone_number": "760-662-3933",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "HAYLEY",
"middle_name": "SUSANNE",
"name_prefix": "Mrs.",
"credential": "MT-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-04",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"deactivation_date": "2019-09-05",
"reactivation_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "AZ",
"license": "13584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.