Connie Jean Mitchell, LCMHC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LCMHC15433 Issued in NC

Practice address

1867 Huntley Way
Burlington, NC 27215-8591

Phone

(208) 304-5325

Fax

(509) 215-2367

NPI assigned

Mar 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Liberty Univ College of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Your Family Counseling Center, LLC

  • Professional Counselor
  • Sandpoint, ID
  • NPI 1750901948

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1295230373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 HUNTLEY WAY",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158591",
            "telephone_number": "208-304-5325",
            "fax_number": "509-215-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 HUNTLEY WAY",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158591",
            "telephone_number": "208-304-5325",
            "fax_number": "509-215-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CONNIE",
        "middle_name": "JEAN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-6756",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "LCMHC15433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin Reed Minter, M.D.
• Minton Eye Care, OD, PLLC
• Jason Minton, OD
• Jean Minton, PT
• Ana Maria Miquel, CRNA
• Samantha Mitchell, LCMHC
• Tori Cidiciqua Mitchell
• Jordan Mitchener
• Mobile FNP Jrjohnson (Mobile FNP JR Johnson PLLC)
• Nikisha Michelle Mock

• Counselor in Burlington, NC
• Providers in Burlington, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.