Marilyn Sue Mitchell, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1159 Issued in AZ

Practice address

11020 N Tatum Blvd
Ste.100
Phoenix, AZ 85028-6072

Phone

(602) 996-8619

Fax

(602) 996-7932

NPI assigned

Jul 19, 2006

Sex

Female

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

Credentials

Doctor of Philosophy

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.

• Community Counseling and Psychotherapy LTD

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1831125293
  NPD (past)
• Kathy Crowley LCSW LLC

  • Clinical Social Worker
  • Glendale, AZ
  • NPI 1275584005
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1285653238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11020 N TATUM BLVD",
            "address_2": "STE.100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286072",
            "telephone_number": "602-996-8619",
            "fax_number": "602-996-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 N TATUM BLVD",
            "address_2": "STE.100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286072",
            "telephone_number": "602-996-8619",
            "fax_number": "602-996-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARILYN",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "1159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin G Mitchell, SLPA
• Lajuana Ebony Mary Mitchell, LPC
• Lindzy Mitchell, LDO
• Maddison Mitchell, RN
• Maeghan Mitchell
• Melissa Marie Mitchell
• Melonie C Mitchell
• Racelle Levette Mitchell
• Renae Tylynne Mitchell, MSN, APRN, FNP-C
• Sara Mitchell, BCBA

• Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.