Individual provider Active NPI

Lesley Nicole Mitchell, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1336307891
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2014003441 Issued in MO
Practice address
285 W Wieuca Rd NE
Atlanta, GA 30342-3321
Phone
(636) 299-6376
Fax
(314) 392-9764
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2014003441 MO Primary
Clinical Social Worker 1041C0700X 3922 GA

Addresses

Primary practice location

285 W Wieuca Rd NE
Atlanta, GA 30342-3321

Mailing address

650 Spyglass Summit Dr
Chesterfield, MO 63017-2143
Phone (636) 299-6376

Other practice location 1

650 Spyglass Summit Dr
Chesterfield, MO 63017-2143
Phone (636) 299-6376

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014003441MOMDClinical Social Worker
3922GAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1336307891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SPYGLASS SUMMIT DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172143",
            "telephone_number": "636-299-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 W WIEUCA RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423321",
            "telephone_number": "636-299-6376",
            "fax_number": "314-392-9764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Spyglass Summit Dr",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630172143",
            "country_code": "US",
            "telephone_number": "636-299-6376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LESLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014003441",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "3922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; 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.