KATIE TACKETT - NPI 1053966168 - Peer Specialist in Dayton, OH

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

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About Katie Tackett NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATIE TACKETT (NPI 1053966168) is an individual peer specialist in Dayton, Ohio, licensed in Ohio (FPS.00417) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1053966168

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameKATIE TACKETT

Location Address526 XENIA AVEDayton, OH 45410-1824

Mailing Address3400 Idylwilde BlvdDayton, OH 45414-5514

Phone(937) 949-1524

Sole ProprietorNo

Enumeration DateAugust 6, 2019

Last NPPES UpdateMay 18, 20262 updates tracked since enumeration

NPPES CertifiedMay 18, 2026

✔ NPI 1053966168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in OH · FPS.00417

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

526 XENIA AVE, Dayton, OH 45410

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