Active NPI
Roxanne Mitchell, MS, LPC
- Counselor
- Auburn Hills, MI
National Provider Identifier
1265817555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401018242
- Practice address
- 1814 Pond Run
Auburn Hills, MI 48326-2768 - Phone
- (248) 340-0559
- NPI assigned
- Jul 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | 6401014385 | MI | |
| Counselor | 101Y00000X | 6401018242 | MI | Primary |
Addresses
Primary practice location
1814 Pond Run
Auburn Hills, MI 48326-2768
Mailing address
162 Lois LN
Mount Clemens, MI 48043-2243
Phone (810) 335-5029
Other practice location 1
26300 Outer Dr
Lincoln Park, MI 48146-2019
Phone (734) 785-7700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 386004868 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Master of Science - Law
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401018242 | MI | MD | Counselor |
| 6401014385 | MI | MD | Point of Service |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wentworth and Associates PC | Current | Accepting new patients |
Locations
11111 Hall Rd
Ste 303
Utica, MI 48317
Phone (586) 739-0902
11111 Hall Rd
Ste 300
Utica, MI 48317
Phone (586) 323-2181
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.
-
- Psychologist
- Utica, MI
- NPI 1306827191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683504000000",
"number": "1265817555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 LOIS LN",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432243",
"telephone_number": "810-335-5029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 POND RUN",
"city": "AUBURN HILLS",
"state": "MI",
"postal_code": "483262768",
"telephone_number": "248-340-0559"
}
],
"practiceLocations": [
{
"address_1": "26300 Outer Dr",
"address_purpose": "LOCATION",
"city": "Lincoln Park",
"state": "MI",
"postal_code": "481462019",
"country_code": "US",
"telephone_number": "734-785-7700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "ROXANNE",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-28",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "MI",
"license": "6401014385",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401018242",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "386004868",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Auburn Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.