Ricky Donald Mitchell, CSAC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003539 Issued in VA

Practice address

261 North St
Bristol, VA 24201-3275

Phone

(276) 254-5445

Fax

(276) 208-8045

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Oct 15, 2024 through Oct 15, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Next Steps Services, Inc.

  • Counselor
  • Bristol, VA
  • NPI 1417596727

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Family Preservation Services, Inc

  • Community/Behavioral Health Agency
  • Clintwood, VA
  • NPI 1134366032
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1457556011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242120352",
            "telephone_number": "276-254-5445",
            "fax_number": "276-206-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 NORTH ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013275",
            "telephone_number": "276-254-5445",
            "fax_number": "276-208-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22417 Watauga Rd",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117065",
            "country_code": "US",
            "telephone_number": "276-254-5445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 W Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242102765",
            "country_code": "US",
            "telephone_number": "276-254-5445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "481 Bradley St SW",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242103051",
            "country_code": "US",
            "telephone_number": "276-254-5445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 Lee Hwy Ste 104-105",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242026025",
            "country_code": "US",
            "telephone_number": "276-254-5445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1280 Browning Holw",
            "address_purpose": "LOCATION",
            "city": "Clintwood",
            "state": "VA",
            "postal_code": "242286074",
            "country_code": "US",
            "telephone_number": "276-254-5445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24658 Dickenson Hwy",
            "address_purpose": "LOCATION",
            "city": "Haysi",
            "state": "VA",
            "postal_code": "242565003",
            "country_code": "US",
            "telephone_number": "276-254-5445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "RICKY",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "credential": "CSAC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0701003539",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010072107",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Hejny
• Miller Family & Sports Chiropractic, LLC
• April D Miller, PTA
• Scott Randolph Miller, D.D.S.
• Tiffany Miller, RN
• Taylor Carol Mitchell
• Sarah Mollohan, PHARMD
• Taylor Moncier, OTR/L
• Laura Olsen Moore, PT
• Imanuel Morenings, D.C.

• Professional Counselor in Bristol, VA
• Providers in Bristol, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.