Nancy Taylor Mitchum, PSYD LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810002730 Issued in VA

Practice address

1709 Colley Ave
Ste 311
Norfolk, VA 23517

Phone

(757) 628-8337

Fax

(757) 628-5911

NPI assigned

Jul 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Little Creek Counseling Ctr

  • Clinical Psychologist
  • Norfolk, VA
  • NPI 1366453482
  NPD (past) Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356364566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 COLLEY AVE",
            "address_2": "STE 311",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23517",
            "telephone_number": "757-628-8337",
            "fax_number": "757-628-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 COLLEY AVE",
            "address_2": "STE 311",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23517",
            "telephone_number": "757-628-8337",
            "fax_number": "757-628-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "NANCY",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "PSYD LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NORTH REGION",
            "identifier": "541592464001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "140543",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khristina Mitchell, LMT
• Madonna Nichole Mitchell
• Martha Elizabeth Mitchell
• Paul Bruce Mitchell Jr., MD
• Shawn B Mitchell, PA-C
• Doris Mitnick, LCSW
• Ranjana Neelanjana Mitra, MD
• Monica Mitta, MD
• Deepak Mittal, MD
• Katelyn Mize, RN, MSN, ACNS-BC

• Clinical Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.