Active NPI
Skyler Mitchell, M.S. CCC-SLP
- Speech-Language Pathologist
- Aberdeen, MD
National Provider Identifier
1124846688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 120165
- Practice address
- 810 Edmund St
Aberdeen, MD 21001-3546 - Phone
- (410) 273-5530
- NPI assigned
- Oct 2, 2024
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 120165 | TX | Primary |
Addresses
Primary practice location
810 Edmund St
Aberdeen, MD 21001-3546
Mailing address
1933 Glenroths Dr
Abingdon, MD 21009-1604
Phone (951) 970-2805
Other practice location 1
600 S Juniata St
Havre DE Grace, MD 21078-3447
Phone (410) 939-6616
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120165 | Other | TX | TEXAS DEPARTMENT OF LICENSING AND REGULATION |
| 14476289 | Other | AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120165 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1124846688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 GLENROTHS DR",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210091604",
"telephone_number": "951-970-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 EDMUND ST",
"city": "ABERDEEN",
"state": "MD",
"postal_code": "210013546",
"telephone_number": "410-273-5530"
}
],
"practiceLocations": [
{
"address_1": "600 S Juniata St",
"address_purpose": "LOCATION",
"city": "Havre DE Grace",
"state": "MD",
"postal_code": "210783447",
"country_code": "US",
"telephone_number": "410-939-6616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "SKYLER",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-02",
"last_updated": "2024-10-02",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "120165",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DEPARTMENT OF LICENSING AND REGULATION",
"identifier": "120165",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION",
"identifier": "14476289",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.