Individual provider Active NPI

Robin Mitchell, LMFT

  • Marriage & Family Therapist
  • Springfield, IL
National Provider Identifier
1033775515
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166000399 Issued in IL
Practice address
5230 6TH Street Frontage Rd E
Springfield, IL 62703-5128
Phone
(217) 585-4700
Fax
(217) 585-5651
NPI assigned
May 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166000399 IL Primary

Addresses

Primary practice location

5230 6TH Street Frontage Rd E
Springfield, IL 62703-5128

Mailing address

5230 6TH Street Frontage Rd E
Springfield, IL 62703-5128
Phone (217) 585-4700

Other identifiers 1

IdentifierTypeStateIssuer
166000399OtherILLICENSED MARRIAGE AND FAMILY THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
166000399ILMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1033775515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 6TH STREET FRONTAGE RD E",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035128",
            "telephone_number": "217-585-4700",
            "fax_number": "217-585-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 6TH STREET FRONTAGE RD E",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035128",
            "telephone_number": "217-585-4700",
            "fax_number": "217-585-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ROBIN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MARRIAGE AND FAMILY THERAPIST",
            "identifier": "166000399",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.