Individual provider Active NPI

Elizabeth Mitchell, M.ED.

  • Professional Counselor
  • Edmond, OK
National Provider Identifier
1295019057
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5358 Issued in OK
Practice address
3839 S Boulevard Ste 200
Edmond, OK 73013-5495
Phone
(918) 638-4219
NPI assigned
Sep 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5358 OK Primary

Addresses

Primary practice location

3839 S Boulevard Ste 200
Edmond, OK 73013-5495

Mailing address

3839 S Boulevard Ste 200
Edmond, OK 73013-5495
Phone (918) 638-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5358OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Dysfunctional Couch Professional CurrentSince Mar 5, 2023 Accepting new patients

Locations

3839 S Boulevard
Ste 200
Edmond, OK 73013
Phone (405) 326-1772

2529 S Kelly Ave
Ste C
Edmond, OK 73013
Phone (405) 445-2323

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": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1295019057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 S BOULEVARD STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135495",
            "telephone_number": "918-638-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 S BOULEVARD STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135495",
            "telephone_number": "918-638-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ELIZABETH",
        "credential": "M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2023-03-03",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.