Active NPI
Tiffanie Renae Ackerson, MT-BC, NMT
- Music Therapist
- Deer Park, TX
National Provider Identifier
1366774283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 07425
- Practice address
- 805 Alyse St
Deer Park, TX 77536-2806 - Phone
- (281) 904-8389
- NPI assigned
- Feb 2, 2010
- Last updated
- Feb 2, 2010
- 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 |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 07425 | IL | Primary |
Addresses
Primary practice location
805 Alyse St
Deer Park, TX 77536-2806
Mailing address
805 Alyse St
Deer Park, TX 77536-2806
Phone (281) 904-8389
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 |
|---|---|---|---|
| 07425 | IL | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265068800000",
"number": "1366774283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 ALYSE ST",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775362806",
"telephone_number": "281-904-8389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 ALYSE ST",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775362806",
"telephone_number": "281-904-8389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERSON",
"first_name": "TIFFANIE",
"middle_name": "RENAE",
"credential": "MT-BC, NMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-02",
"last_updated": "2010-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "IL",
"license": "07425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.