MRS. ANNE C KISSACK LPC
NPI 1710509369
Counselor - Professional in Dallas, TX
About Mrs. Anne C Kissack Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. ANNE C KISSACK LPC (NPI 1710509369) is an individual professional provider in Dallas, Texas, licensed in Texas (78091) and active in the NPI registry since May 2020. She has opted out of Medicare through April 28, 2027.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mrs. Anne C Kissack Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 28, 2025 through April 28, 2027.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Anne Kissack's NPI number?
The NPI number for Anne Kissack is 1710509369. It was assigned to this individual provider in the NPPES registry on May 16, 2020.
Where is Anne Kissack located?
Anne Kissack practices at 8749 Southwestern Blvd Apt 18201, Dallas, TX 75206. The listed phone number is (203) 710-1102.
What is Anne Kissack's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Anne Kissack enrolled in Medicare?
No. Anne Kissack has opted out of Medicare through April 28, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Anne Kissack was last updated on May 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Anne C Kissack, LPC · NPI 1710509369
Professional provider in Dallas, Texas. Individual provider, active in the CMS NPPES registry since May 16, 2020.
## Identity
- **NPI:** 1710509369 (Entity type: Individual)
- **Enumerated:** May 16, 2020
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 78091 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 8749 SOUTHWESTERN BLVD APT 18201, Dallas, TX 75206-2783
- **Phone:** (203) 710-1102
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 28, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** May 16, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1710509369) · Data from the CMS NPPES public registry.