Active NPI
Tiffany Melissa Edwards
- Clinical Psychologist
- Tomball, TX
National Provider Identifier
1649696584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 37633
- Practice address
- 1200 W Main St
Tomball, TX 77375-5522 - Phone
- (917) 651-6474
- NPI assigned
- Mar 17, 2014
- Last updated
- Sep 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | |||
| Clinical Psychologist | 103TC0700X | 37633 | TX | Primary |
Addresses
Primary practice location
1200 W Main St
Tomball, TX 77375-5522
Mailing address
22019 Golden Cedar Dr
Cypress, TX 77433-4647
Phone (917) 651-6474
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 |
|---|---|---|---|
| 37633 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inneresilience Gym, PLLC | Current | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cypress, TX
- NPI 1124708912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1649696584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22019 GOLDEN CEDAR DR",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774334647",
"telephone_number": "917-651-6474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W MAIN ST",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773755522",
"telephone_number": "917-651-6474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "TIFFANY",
"middle_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-17",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "37633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.