Individual provider Active NPI

Jessica Caroline Mitchell, MH25099

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1144025313
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH25099 Issued in FL
Practice address
6804 Porto Fino Cir
Fort Myers, FL 33912-7139
Phone
(239) 239-3075
NPI assigned
Feb 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH25099 FL Primary

Addresses

Primary practice location

6804 Porto Fino Cir
Fort Myers, FL 33912-7139

Mailing address

7035 Babcock Rd
Fort Myers, FL 33967-5830
Phone (239) 287-9631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416000540 FL Practitioner - Mental Health Counselor 5395260061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dura Medical LLCGroup PAC ID 1254672272, 21 clinicians

Practice addresses (Care Compare)

6804 Porto Fino Cir
Suite 1
Fort Myers, FL 33912-7139
Phone (239) 734-3481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH25099FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dura Medical LLC CurrentSince Feb 11, 2025 Accepting new patients

Locations

6804 Porto Fino Cir
Ste 1
Fort Myers, FL 33912
Phone (239) 332-4700

1575 Pine Ridge Rd
Ste 16
Naples, FL 34109
Phone (239) 734-3481

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21560/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1144025313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 BABCOCK RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339675830",
            "telephone_number": "239-287-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 PORTO FINO CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127139",
            "telephone_number": "239-239-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JESSICA",
        "middle_name": "CAROLINE",
        "credential": "MH25099",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH25099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.