Kerry Leon Mizell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701008557 Issued in VA

Practice address

200 Poplar Ave
Newport News, VA 23607-5530

Phone

(757) 715-4566

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1467077032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 POPLAR AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236075530",
            "telephone_number": "757-715-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 POPLAR AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236075530",
            "telephone_number": "757-715-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELL",
        "first_name": "KERRY",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhea Mitchell
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• Tamara N Mitchell, FNP
• Trinity Mitchell, RBT
• Brian Adam Mitnick
• Kristi Vergena Mizelle, M.D.
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• Richard Dale Mocabee, P.T.

• Professional Counselor in Newport News, VA
• Providers in Newport News, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.