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Contact Information

JAMES W MIKESELL, PhD
7000 E GENESEE ST BLDG C
FAYETTEVILLE, NY13066
 Phone: 315-449-0117
 Fax: 315-449-9623
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Neuropsychologist

103G00000X
Indicates primary specialty

NPI Profile & details for JAMES W MIKESELL · (Male)

NPI # 1194816512
Status Active
Credentials PhD
Entity Individual
Enumeration date 09/28/2006
Last updated 06/11/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 010649
  • NY Medicaid 018238858
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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