NPIMap

Organization Active NPI

Colleen a. Mitchell Psychological Services

  • Clinical Psychologist
  • Fort Atkinson, WI
National Provider Identifier
1023506524
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
COLLEEN A. MITCHELL PSYCHOLOGICAL SERVICES
Practice address
211 S. Main Street Suite 104
Fort Atkinson, WI 53538-1894
Phone
(773) 387-0790
NPI assigned
Apr 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Authorized official

Name
Colleen Mitchell, PSY.D.
Title
Clinical Psychologist
Phone
(773) 387-0790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

211 S. Main Street Suite 104
Fort Atkinson, WI 53538-1894

Mailing address

211 S. Main Street Suite 104
Fort Atkinson, WI 53538-1894
Phone (773) 387-0790

National Provider Directory

National Provider Directory

Locations

211 S Main St
Ste 104
Fort Atkinson, WI 53538
Phone (773) 387-0790

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1023506524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S. MAIN STREET SUITE 104",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381894",
            "telephone_number": "773-387-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S. MAIN STREET SUITE 104",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381894",
            "telephone_number": "773-387-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEEN A. MITCHELL PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "773-387-0790",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.