Individual provider Active NPI

Patrick Hallam Mitchell, LCSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1366418873
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114903 Issued in MI
Practice address
2350 Green Rd Ste 160
Ann Arbor, MI 48105-1572
Phone
(517) 882-3732
Fax
(517) 882-3633
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149023771 IL
Social Worker 104100000X 6801114903 MI
Clinical Social Worker 1041C0700X R0583761 NY
Clinical Social Worker 1041C0700X 6801114903 MI Primary

Addresses

Primary practice location

2350 Green Rd Ste 160
Ann Arbor, MI 48105-1572

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (517) 492-0784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220815002265 MI Practitioner - Clinical Social Worker 1658267950 Reassigns benefits to 1 organization
I20231030001282 IL Practitioner - Clinical Social Worker 1658267950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

2350 Green Rd
Suite 150 160
Ann Arbor, MI 48105-1599
Phone (734) 285-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801114903MIMDSocial Worker
149023771ILMDClinical Social Worker
R0583761NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Sep 18, 2023 Accepting new patients
Pathways, Inc. Social Worker PastSince Oct 1, 1999 Accepting new patients
Erwin Psychiatric NP PLLC PastSince Mar 24, 2024 Accepting new patients
Patrick H. Mitchell Clinical Past Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

180 W Park Ave
Ste 150
Elmhurst, IL 60126
Phone (630) 235-8089

Organizations & group practices 6

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1366418873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "517-492-0784",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 GREEN RD STE 160",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051572",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PATRICK",
        "middle_name": "HALLAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023771",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801114903",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0583761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.