Active NPI
Sara Mitchell, LLPC
- Professional Counselor
- Grand Rapids, MI
National Provider Identifier
1114467966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401015269
- Practice address
- 4700 E Beltine Ave
Grand Rapids, MI 49525 - Phone
- (616) 365-0303
- NPI assigned
- Feb 27, 2017
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401015269 | MI | Primary |
Addresses
Primary practice location
4700 E Beltine Ave
Grand Rapids, MI 49525
Mailing address
447 Chasseral Dr NW
Apt 1D
Comstock Park, MI 49321-9023
Phone (616) 856-9005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401015269 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1114467966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 CHASSERAL DR NW",
"address_2": "APT 1D",
"city": "COMSTOCK PARK",
"state": "MI",
"postal_code": "493219023",
"telephone_number": "616-856-9005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 E BELTINE AVE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49525",
"telephone_number": "616-365-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "SARA",
"name_prefix": "Mrs.",
"credential": "LLPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-27",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401015269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.