Individual provider Active NPI

David Stanley Mitchell

  • Mental Health Counselor
  • Everett, WA
National Provider Identifier
1215464656
Registry record updated May 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
811 Madison St
Everett, WA 98203-4543
Phone
(425) 212-4200
NPI assigned
May 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

811 Madison St
Everett, WA 98203-4543

Mailing address

31404 E Kennedy Rd NE Unit 1
Benton City, WA 99320-6518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805002923 WI Practitioner - Mental Health Counselor 5991242216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Mental Health Center, Inc. CurrentSince May 24, 2024 Accepting new patients

Locations

25 Kessel Ct
Ste 105
Madison, WI 53711
Phone (608) 280-2636

49 Kessel Ct
Madison, WI 53711
Phone (608) 280-2510

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": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494892800000",
    "number": "1215464656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31404 E KENNEDY RD NE UNIT 1",
            "city": "BENTON CITY",
            "state": "WA",
            "postal_code": "993206518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 MADISON ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982034543",
            "telephone_number": "425-212-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DAVID",
        "middle_name": "STANLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-16",
        "last_updated": "2017-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.