Tanisha Jennifer Pakanayeva, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18312 Issued in NC

Practice address

6849 Fairview Rd Ste 702
Charlotte, NC 28210-3393

Phone

(980) 308-4500

Fax

(980) 458-6037

NPI assigned

May 15, 2023

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• The Jenkins Creative Counseling Center, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1447845821
  NPD

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1043901838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6849 FAIRVIEW RD STE 702",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103393",
            "telephone_number": "980-308-4500",
            "fax_number": "980-458-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6849 FAIRVIEW RD STE 702",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103393",
            "telephone_number": "980-308-4500",
            "fax_number": "980-458-6037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1913 J N Pease Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282624537",
            "country_code": "US",
            "telephone_number": "980-308-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAKANAYEVA",
        "first_name": "TANISHA",
        "middle_name": "JENNIFER",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "18312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooks Paine, DDS
• Pair It Transportation LLC
• Diane Pak
• Grace E Pak, MD
• Katherine Sarah Pak, D.D.S.
• Sridhar Earni Pal, MD
• Palace at Home Care Agency LLC
• Amy Hendricks Palacios, NP-C
• Jyothi Paladugu, M.D.
• Guhapriya Palaniswamy, MD

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.