Barry A. Mitchell, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

SI1706 Issued in NJ

Practice address

743 Northfield Ave
Suite #3
West Orange, NJ 07052-1107

Phone

(973) 736-3042

Fax

(908) 889-9370

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1396843983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 NORTHFIELD AVE",
            "address_2": "SUITE #3",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521107",
            "telephone_number": "973-736-3042",
            "fax_number": "908-889-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 NORTHFIELD AVE",
            "address_2": "SUITE #3",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521107",
            "telephone_number": "973-736-3042",
            "fax_number": "908-889-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BARRY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI1706",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "006708",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1826301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.