Brenton Joo Mitchell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC015196 Issued in PA

Practice address

141 E Fairmount Ave
State College, PA 16801-5315

Phone

(814) 234-3464

NPI assigned

Aug 9, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Claire Van Ogtrop Psychotherapy, LLC

  • Clinical Social Worker
  • State College, PA
  • NPI 1760271068
  NPD
• Jessica C Effrig Psychotherapy LLC

  • Community/Behavioral Health Agency
  • State College, PA
  • NPI 1740703636
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1003599739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E FAIRMOUNT AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015315",
            "telephone_number": "814-234-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E FAIRMOUNT AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015315",
            "telephone_number": "814-234-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRENTON",
        "middle_name": "JOO",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC015196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Mills, LAPC
• Amanda Diane Milner, LPC
• Milton S Hershey Medical Center Physicians Group
• Scott M Minor, PA-C
• Kevin Allan Mishock, D.O.
• Gary Alan Mitchell, MD
• Kimberly Ann Mitchell, M.A., L.P.C.
• Pamela Ann Mitchell, P.T.
• Maria Moeslein, LBS
• Mehwish Moinuddin, D.O.

• Professional Counselor in State College, PA
• Providers in State College, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.