Individual provider · Type 1 NPI

Katie Tackett

Peer Specialist · Dayton, OH

NPI number 1053966168 Active

Practice location

526 Xenia Ave
Dayton, OH 45410-1824

Call (937) 949-1524 Map

Mailing address

3400 Idylwilde Blvd
Dayton, OH 45414-5514

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XFPS.00417 (OH)

Peer Specialist: 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.

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About NPI 1053966168

Katie Tackett's National Provider Identifier is 1053966168, issued on Aug 6, 2019. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Dayton, OH. The record was last updated on May 18, 2026.