Individual provider Active NPI

Tiffany Dawn Yolles, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spring, TX
National Provider Identifier
1427735174
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1102151 Issued in TX
Practice address
200 Valley Wood Dr Ste B300
Spring, TX 77380-5410
Phone
(936) 689-2536
NPI assigned
Jul 3, 2023
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1102151 TX Primary

Addresses

Primary practice location

200 Valley Wood Dr Ste B300
Spring, TX 77380-5410

Mailing address

54 Canopy Green Dr
Tomball, TX 77375-1078
Phone (936) 689-2536

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
1102151TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Life Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jul 16, 2023 Accepting new patients

Locations

200 Valley Wood Dr
Ste B300
The Woodlands, TX 77380
Phone (281) 292-8227

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1427735174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CANOPY GREEN DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773751078",
            "telephone_number": "936-689-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALLEY WOOD DR STE B300",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773805410",
            "telephone_number": "936-689-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOLLES",
        "first_name": "TIFFANY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1102151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.