Audrey A Mitchell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34098 Issued in ID

Practice address

3350 W Americana Ter Ste 210B
Boise, ID 83706-2521

Phone

(208) 402-6325

NPI assigned

Oct 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northend Wellness, LLC

  • Psychologist
  • Boise, ID
  • NPI 1306230958
  NPD (past)

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1205231834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4863 S GREENACRES WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095276",
            "telephone_number": "208-713-5454",
            "fax_number": "208-706-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W AMERICANA TER STE 210B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062521",
            "telephone_number": "208-402-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 E. Louise Dr.",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "83642",
            "country_code": "US",
            "telephone_number": "208-706-7053",
            "fax_number": "208-706-7059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AUDREY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "34098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sayed Mazharuddin Mirbacha
• Brooke F Mischkot, MD
• Emily Misner
• Dinu Mistry Wolf, MD
• Kelisha Mistry, RN
• Davida Helene Mitchell, L.AC.
• Duncan Forrest Mitchell, LCSW
• Eloise H Mitchell
• Gregory D Mitchell, M.A, L.A.T., A.T.C.
• Sam Mitchell, D.C.

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.