Active NPI
Tahlib James McMicheaux I
- Mental Health Counselor
- Indio, CA
National Provider Identifier
1730546706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- N257711
- Practice address
- 47825 Oasis St
Indio, CA 92201-6950 - Phone
- (760) 863-8455
- Fax
- (760) 863-8587
- NPI assigned
- Jan 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | N257711 | CA | Primary |
Addresses
Primary practice location
47825 Oasis St
Indio, CA 92201-6950
Mailing address
47825 Oasis St
Indio, CA 92201-6950
Phone (760) 863-8455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171M00000X | Other | CA | MEDICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| N257711 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1730546706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47825 OASIS ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "760-863-8455",
"fax_number": "760-863-8587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47825 OASIS ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "760-863-8455",
"fax_number": "760-863-8587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMICHEAUX",
"first_name": "TAHLIB",
"middle_name": "JAMES",
"name_suffix": "I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-21",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "N257711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "171M00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.