Individual provider Active NPI

Ava Mitchell

  • Social Worker
  • Portland, OR
National Provider Identifier
1467146191
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
811 SW 6TH Ave Ste 1000
Portland, OR 97204-1345
Phone
(503) 334-3035
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

811 SW 6TH Ave Ste 1000
Portland, OR 97204-1345

Mailing address

6449 SW Loop Dr
Portland, OR 97221-3363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

811 SW 6TH Ave
Suite 1000
Portland, OR 97204-1345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services Connection LLC Social Worker CurrentSince Jun 11, 2023 Accepting new patients

Locations

811 SW 6th Ave
Ste 1000
Portland, OR 97204
Phone (503) 334-3035

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1467146191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6449 SW LOOP DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972213363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SW 6TH AVE STE 1000",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041345",
            "telephone_number": "503-334-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.