Active NPI
Dejia Mitchell
- Behavior Technician
- Virginia Beach, VA
National Provider Identifier
1144819756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB648437
- Practice address
- 4765 Alicia Dr Apt 214
Virginia Beach, VA 23462-3802 - Phone
- (708) 546-8097
- NPI assigned
- Jan 18, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB648437 | VA | Primary |
Addresses
Primary practice location
4765 Alicia Dr Apt 214
Virginia Beach, VA 23462-3802
Mailing address
4765 Alicia Dr Apt 214
Virginia Beach, VA 23462-3802
Phone (708) 546-8097
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 |
|---|---|---|---|
| BACB648437 | VA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610928000000",
"number": "1144819756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4765 ALICIA DR APT 214",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234623802",
"telephone_number": "708-546-8097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4765 ALICIA DR APT 214",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234623802",
"telephone_number": "708-546-8097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "DEJIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-18",
"last_updated": "2021-01-18",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "BACB648437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.