Active NPI
Danielle Mitsch, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Severna Park, MD
National Provider Identifier
1063081206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R214196
- Practice address
- 877 Baltimore Annapolis Blvd Ste 202
Severna Park, MD 21146-4716 - Phone
- (410) 684-3806
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R214196 | MD | Primary |
Addresses
Primary practice location
877 Baltimore Annapolis Blvd Ste 202
Severna Park, MD 21146-4716
Mailing address
267 Cape Saint John Rd
Annapolis, MD 21401-7232
Phone (631) 523-3458
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 25, 2021 through Aug 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R214196 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Interoperability endpoints
- waypointwellnesscenter.daniellemitsch@150898.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1063081206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 CAPE SAINT JOHN RD",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017232",
"telephone_number": "631-523-3458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 BALTIMORE ANNAPOLIS BLVD STE 202",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211464716",
"telephone_number": "410-684-3806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITSCH",
"first_name": "DANIELLE",
"credential": "PMHNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R214196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.