Joseph Michael Mitrovich, PSY.D.
Individual provider Active NPI Clinical Psychologist · Steilacoom, WA
NPI 1134474794 · NPPES record last updated Jul 19, 2012
Key facts
- NPI
- 1134474794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY 60218793 (WA)
- Practice address
- 1715 Lafayette St
Steilacoom, WA 98388-1327 - Phone
- (253) 514-2460
- NPI assigned
- Jul 19, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1003 S 5TH St 4TH FL
Tacoma, WA 98405-4210
PO Box 5299 Ms 603
Tacoma, WA 98415-0299
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2026 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60218793 | WA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | PY 60218793 | WA | Yes |
Addresses
Primary practice location
1715 Lafayette St
Steilacoom, WA 98388-1327
Mailing address
1715 Lafayette St
Steilacoom, WA 98388-1327
Phone (253) 514-2460
Other providers in Steilacoom, WA
- Thomas J McAvoy
- Michael Edward McDade
- Angela Kay McGee
- Laura Ann McGowan
- Michael McDade, D.D.S.,P.L.L.C.
- Sheryl Lynn Morelli
- Pacific Northwest Neurology PLLC
- Iona May Parker
- Roxanne S Peterson
- Jordan Patrick Sanders
All providers in Steilacoom, WA · Clinical Psychologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.