Jennifer Jo Tackett, ART THERAPIST ATR

Primary specialty

Art TherapistTaxonomy code 221700000X

Practice address

1669 W Maple Rd
Birmingham, MI 48009-1230

Phone

(248) 646-3347

NPI assigned

Sep 1, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Variety Far Conservatory

  • Developmentally Disabled Services Day Training Agency
  • Birmingham, MI
  • NPI 1053566398
  NPD (past)

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1720395452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 W MAPLE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091230",
            "telephone_number": "248-646-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 W MAPLE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091230",
            "telephone_number": "248-646-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JENNIFER",
        "middle_name": "JO",
        "credential": "ART THERAPIST ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Harry Sutherland, D.D.S.
• Richard W Suttle, P.A.
• Kelly Ann Sweeney
• Synergy Wellness
• Haley Sztykiel, LMSW
• Takako Benn MD PLLC
• Beverly Steinman Talan, PH.D.
• Tangelo - Intend, Inc.
• Katherine Marie Tarpeh, M.S.E.
• Bradley Thomas Tata, MT-BC

• Art Therapist in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Art Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.