Individual provider Active NPI

Brenda Mitchell, PSYD

  • Clinical Neuropsychologist
  • Providence, RI
National Provider Identifier
1275319121
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS02462 Issued in RI
Practice address
1 Hoppin St Ste 204
Providence, RI 02903-4141
Phone
(401) 444-8945
Fax
(401) 444-8742
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS02462 RI Primary

Addresses

Primary practice location

1 Hoppin St Ste 204
Providence, RI 02903-4141

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Other practice location 1

1 Hoppin St Ste 309
Providence, RI 02903-4141
Phone (401) 444-4515

Other practice location 2

593 Eddy St
Providence, RI 02903-4923
Phone (401) 432-1000

Other practice location 3

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1275319121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST STE 204",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141",
            "telephone_number": "401-444-8945",
            "fax_number": "401-444-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hoppin St Ste 309",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034141",
            "country_code": "US",
            "telephone_number": "401-444-4515",
            "fax_number": "401-444-7018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 Veterans Memorial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "RI",
            "postal_code": "029155061",
            "country_code": "US",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRENDA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS02462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.