Individual provider Active NPI

Cheryl Diane Mikeska, MA

  • Professional Counselor
  • Bryan, TX
National Provider Identifier
1295991958
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12244 Issued in TX
Practice address
2813 Apple Creek Cir
Bryan, TX 77802-2904
Phone
(979) 774-5011
Fax
(979) 774-5011
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 12244 TX Primary

Addresses

Primary practice location

2813 Apple Creek Cir
Bryan, TX 77802-2904

Mailing address

2402 Broadmoor Dr Ste A102
Bryan, TX 77802-2800
Phone (979) 774-5011

Other identifiers 1

IdentifierTypeStateIssuer
1426462-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701001377 TX Practitioner - Mental Health Counselor 2163935347 Practice locations: Bryan, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1716 Briarcrest Dr
Suite 602
Bryan, TX 77802-2751
Phone (979) 324-5707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12244TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tammera S. Brown Professional PastSince Jul 31, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1295991958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 BROADMOOR DR STE A102",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022800",
            "telephone_number": "979-774-5011",
            "fax_number": "979-774-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 APPLE CREEK CIR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022904",
            "telephone_number": "979-774-5011",
            "fax_number": "979-774-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKESKA",
        "first_name": "CHERYL",
        "middle_name": "DIANE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "12244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1426462-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.