Amelia Jo Mitchell, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2012001260 Issued in MO

Practice address

1526 Claytonia Ter
Saint Louis, MO 63117-2126

Phone

(805) 674-2595

NPI assigned

May 17, 2006

Last updated

Sep 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1164474904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 CLAYTONIA TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631172126",
            "telephone_number": "805-674-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 CLAYTONIA TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631172126",
            "telephone_number": "805-674-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AMELIA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2012001260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2012001260",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shundra Mitchell-Holliday
• Adam James Mitchell
• Alice Mitchell, RN
• Alissha Renee Mitchell
• Allison Denise Mitchell, MD
• Chanel Mitchell, MSW
• Chase Mitchell
• Cory Mitchell
• Craig Mitchell, DO
• Felicia P Mitchell

• Clinical Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.