Sherry L Tissaw

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0014894 Issued in CO

Practice address

1303 E Central Ave
Bismarck, ND 58501-2066

Phone

(701) 323-5626

NPI assigned

Jun 29, 2016

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1477904696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 E CENTRAL AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012066",
            "telephone_number": "701-323-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 E CENTRAL AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012066",
            "telephone_number": "701-323-5626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "796 Megan",
            "address_purpose": "LOCATION",
            "city": "Rifle",
            "state": "CO",
            "postal_code": "816504703",
            "country_code": "US",
            "telephone_number": "970-625-3582",
            "fax_number": "970-625-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISSAW",
        "first_name": "SHERRY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0014894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrianna Gabrielle Tincher
• Amber Tincher, MD
• Michelle R Tincher, MD
• Mandi Tipton, LAC
• Janice Kay Tishmack, L.S.W.
• Lucas Titus, MD
• Corrie Tivis, RN
• Karen S Tjaden, M.D.
• Krystal Lee Tkach, CNA
• Chandler Tobeck, MA, MPH

• Mental Health Counselor in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.