Active NPI
Thomas Mitchell, LPC, NCC
- Professional Counselor
- Covington, LA
National Provider Identifier
1144628785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7325
- Practice address
- 223 W 28TH Ave
Covington, LA 70433 - Phone
- (731) 267-2521
- Fax
- (985) 892-3875
- NPI assigned
- Dec 14, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7325 | LA | Primary |
| Professional Counselor | 101YP2500X | LPC0000003227 | TN |
Addresses
Primary practice location
223 W 28TH Ave
Covington, LA 70433
Mailing address
223 W 28TH Ave
Covington, LA 70433-2119
Phone (731) 267-2521
Other practice location 1
1430 N Highland Ave
Jackson, TN 38301-3404
Phone (731) 267-2521
Other practice location 2
223 W 28th Ave
Covington, LA 70433
Phone (731) 267-2521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q022788 | Medicaid | TN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC0000003227 | TN | MD | Professional Counselor |
| 7325 | LA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561161600000",
"number": "1144628785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 W 28TH AVE",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704332119",
"telephone_number": "731-267-2521",
"fax_number": "985-892-3875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 W 28TH AVE",
"city": "COVINGTON",
"state": "LA",
"postal_code": "70433",
"telephone_number": "731-267-2521",
"fax_number": "985-892-3875"
}
],
"practiceLocations": [
{
"address_1": "1430 N Highland Ave",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "TN",
"postal_code": "383013404",
"country_code": "US",
"telephone_number": "731-267-2521",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "223 W 28th Ave",
"address_purpose": "LOCATION",
"city": "Covington",
"state": "LA",
"postal_code": "70433",
"country_code": "US",
"telephone_number": "731-267-2521",
"fax_number": "985-892-3875",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "LPC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-14",
"last_updated": "2019-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "7325",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "LPC0000003227",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q022788",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.