Jay E Mitchell, MA, MFT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

61315505 Issued in WA

Practice address

110 W Crawford St Ste J
Deer Park, WA 99006-5356

Phone

(509) 818-6844

NPI assigned

Apr 5, 2021

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jay E Mitchell Professional name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

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  • Marriage & Family Therapist
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  • NPI 1780471557
  Medicare reassignment NPD Authorized official
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  dba Northeast Washington Alliance Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Colville, WA
  • NPI 1922517192
  NPD (past)

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1013596212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1641",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990061641",
            "telephone_number": "509-818-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W CRAWFORD ST STE J",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990065356",
            "telephone_number": "509-818-6844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Clay Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chewelah",
            "state": "WA",
            "postal_code": "991098936",
            "country_code": "US",
            "telephone_number": "509-684-4597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "165 E Hawthorne Ave",
            "address_purpose": "LOCATION",
            "city": "Colville",
            "state": "WA",
            "postal_code": "991142629",
            "country_code": "US",
            "telephone_number": "509-684-4597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JAY",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2022-10-07",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "61315505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "MITCHELL",
            "middle_name": "E",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Ward Merkeley, MD
• Greg W Miller, DDS
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• Julie A Moran, M.D.
• Jennifer Lynette Morrill, LMP

• Counselor in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.