Provider Demographics
NPI:1922192038
Name:MESKE, CAROLYN (LMFT LPCC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:MESKE
Suffix:
Gender:F
Credentials:LMFT LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 BELSLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5055
Mailing Address - Country:US
Mailing Address - Phone:218-287-4338
Mailing Address - Fax:218-287-5928
Practice Address - Street 1:891 BELSLY BLVD
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5055
Practice Address - Country:US
Practice Address - Phone:218-287-4338
Practice Address - Fax:218-287-5928
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND101719135101YP2500X
MN796106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013080OtherPREFERRED ONE
MN547023400Medicaid
62-72939OtherUBH
HP23800OtherHEALTH PARTNERS
MN140L5MEOtherBLUE CROSS
ND1922192038OtherND BLUE CROSS BLUE SHIELD
MN547023400Medicaid