Individual provider Active NPI

Felicia Marie Mitchell, LMSW

  • Social Worker
  • Sacaton, AZ
National Provider Identifier
1164626172
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
50420 Issued in TX
Practice address
483 W. Seed Farm Rd.
Sacaton, AZ 85247
Phone
(602) 528-1340
Fax
(602) 528-1296
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 50420 TX Primary

Addresses

Primary practice location

483 W. Seed Farm Rd.
Sacaton, AZ 85247

Mailing address

P.O. Box 115
Sacaton, AZ 85247-0115
Phone (602) 528-1340

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAZ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
50420TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Past Accepting new patients

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164626172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 115",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "852470115",
            "telephone_number": "602-528-1340",
            "fax_number": "602-528-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM RD.",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85247",
            "telephone_number": "602-528-1340",
            "fax_number": "602-528-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "FELICIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "50420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacaton, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.