Individual provider Active NPI

Jonathan Stein Mitchell, MA, LPC

  • Clinical Social Worker
  • Durango, CO
National Provider Identifier
1356643696
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5342 Issued in CO
Practice address
466 S. Skylane Dr.
Open Sky Wilderness Therapy
Durango, CO 81303
Phone
(970) 382-8181
Fax
(970) 382-9494
NPI assigned
Nov 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5342 CO Primary

Addresses

Primary practice location

466 S. Skylane Dr.
Open Sky Wilderness Therapy
Durango, CO 81303

Mailing address

PO Box 2201
Open Sky Wilderness Therapy
Durango, CO 81302-2201
Phone (970) 382-8181

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 Arts

State licenses

LicenseStateTypeSpecialty
5342COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Acf Enterprises, LLC Past Accepting new patients

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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1356643696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2201",
            "address_2": "OPEN SKY WILDERNESS THERAPY",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813022201",
            "telephone_number": "970-382-8181",
            "fax_number": "970-382-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 S. SKYLANE DR.",
            "address_2": "OPEN SKY WILDERNESS THERAPY",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81303",
            "telephone_number": "970-382-8181",
            "fax_number": "970-382-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JONATHAN",
        "middle_name": "STEIN",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "5342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.