Thomas Pollard Mitchell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8040 Issued in FL

Practice address

21 Sandpiper Dr
St Augustine, FL 32080-6987

Phone

(914) 475-7204

Fax

(904) 461-1587

NPI assigned

Mar 8, 2006

Sex

Male

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

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1205804192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SANDPIPER DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806987",
            "telephone_number": "904-461-1587",
            "fax_number": "904-461-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SANDPIPER DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806987",
            "telephone_number": "914-475-7204",
            "fax_number": "904-461-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "THOMAS",
        "middle_name": "POLLARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Sue Mitchell, AUD
• Brendan Mitchell, NSSP
• Margaret Mitchell
• Matthew Mitchell, MD
• Terrence Mitchell
• Georgia Michelle Mobley
• Tina Lynne Mobley, APRN
• Modern Therapy & Counseling, LLC
• Laura Moerman, OTR
• Shawna Moinipour, O.D.

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.