Kirsten L Mitchell, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007177 Issued in IL

Practice address

2081 Calistoga Dr Ste 3N
New Lenox, IL 60451-4834

Phone

(815) 277-9906

Fax

(815) 277-9907

NPI assigned

Jan 10, 2007

Last updated

Sep 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neuro Assessment Services PLLCGroup PAC ID 5496133662, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmitchell8336@direct.riversidehealthcare.net

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.

• Neuro Assessment Services PLLC

  • Clinical Psychologist
  • New Lenox, IL
  • NPI 1922745546
  Medicare reassignment Care Compare group NPD
• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment NPD
• Riverside Health System

  dba Psychiatric Associates

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1053460634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 CALISTOGA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604514831",
            "telephone_number": "815-277-9906",
            "fax_number": "815-277-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 CALISTOGA DR STE 3N",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604514834",
            "telephone_number": "815-277-9906",
            "fax_number": "815-277-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIRSTEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmitchell8336@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "350 N Wall St",
            "address_2": "4th Floor Rehab Unit",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Milano, FNP-BC
• Randi Milstead
• Rebecca Mireles, NP
• Carla C Mistro, CNM
• Kimberly J. Mitchell, MD
• Taryn Mitchell
• Mohammad Alkhudari LTD
• Yousuf Mohammed, M.D.
• Anju Mohan, MD
• Ashif Khaled Molla, MD

• Clinical Psychologist in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.