Colleen Denise Mitchell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05644 Issued in MD

Practice address

8101 Sandy Spring Rd
Suite 100F
Laurel, MD 20707-3596

Phone

(951) 536-3682

NPI assigned

Feb 28, 2007

Last updated

Feb 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Colleen D Mitchell, PHD, LLC

  • Clinical Psychologist
  • Laurel, MD
  • NPI 1730547266

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1184751604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 TURBRIDGE DR",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208662009",
            "telephone_number": "301-890-0214",
            "fax_number": "301-890-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 SANDY SPRING RD",
            "address_2": "SUITE 100F",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073596",
            "telephone_number": "951-536-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COLLEEN",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000002884",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miso Medical Center
• Miso Medical Center
• Nadine Carole Missiet Fogoum, CRNP
• Mitchell a Barber DPM ASC LLC
• Mitchell a Barber DPM LLC
• Denise Louise Mitchell, LCPC
• Evelyn Elizabeth Mitchell, LPC
• Sonya Mitchell, OT
• Soma Mitra, M.D.
• Mivc ASC, LLC

• Clinical Psychologist in Laurel, MD
• Providers in Laurel, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.