Active NPI
Avanelle Mitchell
- Speech-Language Pathologist
- Machias, ME
National Provider Identifier
1063079895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP4415
- Practice address
- 34 Downeast Dr
Machias, ME 04654-1348 - Phone
- (207) 255-1974
- Fax
- (207) 255-6457
- NPI assigned
- May 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP4415 | ME | Primary |
Addresses
Primary practice location
34 Downeast Dr
Machias, ME 04654-1348
Mailing address
34 Downeast Dr
Machias, ME 04654-1348
Phone (207) 255-1974
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP4415 | ME | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765756800000",
"number": "1063079895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 DOWNEAST DR",
"city": "MACHIAS",
"state": "ME",
"postal_code": "046541348",
"telephone_number": "207-255-1974",
"fax_number": "207-255-6457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 DOWNEAST DR",
"city": "MACHIAS",
"state": "ME",
"postal_code": "046541348",
"telephone_number": "207-255-1974",
"fax_number": "207-255-6457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "AVANELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2025-12-15",
"certification_date": "2025-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ME",
"license": "SP4415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Machias, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.