Mikesell, James W

Mikesell, James W is an sole proprietor health care provider with primary practice located at 7000 E Genesee St Bldg C , Fayetteville NY 13066. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Mikesell, James W can be contacted via phone (315) 449-0117.

Contact Information

Primary practice address
7000 E Genesee St Bldg C Fayetteville NY 13066
Phone: (315) 449-0117
Fax: (315) 449-9623
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 010649 New York

Profile Details

NPI number 1194816512
LBN Legal business name Mikesell, James W
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2006
Last updated Jun 11th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194816512 NPPES
New York MEDICAID 018238858

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