Teresa Danielle Mitchem, MS

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

100523 Issued in FL

Practice address

414 Lake Howell Rd
Maitland, FL 32751-5900

Phone

(407) 637-2633

NPI assigned

Aug 5, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Bridges International Centers for Recovery and Reentry, Inc.

  • Community/Behavioral Health Agency
  • Orlando, FL
  • NPI 1487172110

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official
• Change in Motion

  • Mental Health Counselor
  • Winter Park, FL
  • NPI 1821469396
  NPD (past)

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

{
    "created_epoch": "1344124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1225385602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 LAKE HOWELL RD",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515900",
            "telephone_number": "407-637-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 LAKE HOWELL RD",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515900",
            "telephone_number": "407-637-2633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 Metrocenter Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "32835",
            "country_code": "US",
            "telephone_number": "407-218-4791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHEM",
        "first_name": "TERESA",
        "middle_name": "DANIELLE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-05",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": "100523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105479600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013510800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philmaris Miranda
• Billie Mitchell, LMHC
• Jennifer Mitchell
• Judith Rebecca Mitchell, LCSW
• Panya Mitchell
• MNH Gi Anesthesia & Pain Management LLC
• MNH Gi Surgical Center LLC
• MNH Surgical Center Inc
• Isabel L Moczo, MASTERS
• Kathryn Moffitt, PTA

• Case Management Agency in Maitland, FL
• Providers in Maitland, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.