JEAN KESNOLD MESIDOR PHD
NPI 1891210399
Psychologist in Immokalee, FL

Active since August 07, 2017PECOS Enrolled
1454 MADISON AVE W, IMMOKALEE, FL 34142(239) 658-3000(239) 658-3199 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 17, 2018, Aug 7, 2017 (2 updates tracked since 2017).

About Jean Kesnold Mesidor Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEAN KESNOLD MESIDOR PHD (NPI 1891210399) is an individual psychologist in Immokalee, Florida and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Naples, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1891210399
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJEAN KESNOLD MESIDORCredential: PHD
Location Address1454 MADISON AVE WImmokalee, FL 34142-2200
Mailing Address16 Atlantic Ave Fl 2Lynbrook, NY 11563-3046 · (516) 593-1380 · Fax (516) 977-7451
Fax(239) 658-3199
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateAugust 7, 2017
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
NPI 1891210399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1454 MADISON AVE W, Immokalee, FL 34142

Secondary Practice Location 1

Location 11755 Heritage Trl Ste 604Naples, FL 34112-7600 · Phone (239) 658-3715 · Fax (239) 353-4231

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Jean Kesnold Mesidor Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365716081
PECOS Enrollment IDI20170919003819
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Pediatric Dentistry)
1454 MADISON AVE W
IMMOKALEE, FL 34142
Dentist
1454 MADISON AVE W
IMMOKALEE, FL 34142
Nurse Practitioner (Family)
1454 MADISON AVE W
IMMOKALEE, FL 34142
Dentist
1454 MADISON AVE W
IMMOKALEE, FL 34142
Clinic/Center (Federally Qualified Health Center (FQHC))
1454 MADISON AVE W
IMMOKALEE, FL 34142
Dentist (General Practice)
1454 MADISON AVE W
IMMOKALEE, FL 34142
Dietitian, Registered
1454 MADISON AVE W
IMMOKALEE, FL 34142
General Practice
1454 MADISON AVE W
IMMOKALEE, FL 34142

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 Jean Mesidor's NPI number?

The NPI number for Jean Mesidor is 1891210399. It was assigned to this individual provider in the NPPES registry on August 7, 2017.

Where is Jean Mesidor located?

Jean Mesidor practices at 1454 Madison Ave W, Immokalee, FL 34142. The listed phone number is (239) 658-3000.

What is Jean Mesidor's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jean Mesidor enrolled in Medicare?

Yes. Jean Mesidor is registered in the Medicare PECOS enrollment system.

What insurance does Jean Mesidor accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Jean Mesidor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jean Mesidor was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.