Individual provider Active NPI

Cheryl R Mesikano, LPC, LCDC, MAC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1164941076
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75272 Issued in TX
Practice address
3010 LBJ Fwy Ste 1270
Dallas, TX 75234-7770
Phone
(469) 540-3182
NPI assigned
Sep 12, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13206 TX
Professional Counselor 101YP2500X 75272 TX Primary

Addresses

Primary practice location

3010 LBJ Fwy Ste 1270
Dallas, TX 75234-7770

Mailing address

3010 LBJ Fwy Ste 1270
Dallas, TX 75234-7770
Phone (469) 540-3182

Other practice location 1

3010 Lbj Fwy Fl 12
Dallas, TX 75234-2710
Phone (469) 540-3182

Other practice location 2

3010 Lbj Fwy Fl 12
Dallas, TX 75234-2710
Phone (469) 540-3182

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

LicenseStateTypeSpecialty
13206TXMDChiropractor
75272TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164941076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 LBJ FWY STE 1270",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347770",
            "telephone_number": "469-540-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 LBJ FWY STE 1270",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347770",
            "telephone_number": "469-540-3182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3010 Lbj Fwy Fl 12",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752342710",
            "country_code": "US",
            "telephone_number": "469-540-3182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3010 Lbj Fwy Fl 12",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752342710",
            "country_code": "US",
            "telephone_number": "469-540-3182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MESIKANO",
        "first_name": "CHERYL",
        "middle_name": "R",
        "credential": "LPC, LCDC, MAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13206",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.