Active NPI
Jared Mitchell
- Clinical Social Worker
- Fort Gregg Adams, VA
National Provider Identifier
1477405561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904015178
- Practice address
- 700 24TH St
Fort Gregg Adams, VA 23801-1716 - Phone
- (804) 734-9000
- NPI assigned
- Feb 11, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904015178 | VA | Primary |
Addresses
Primary practice location
700 24TH St
Fort Gregg Adams, VA 23801-1716
Mailing address
2430 Hoxton Rd Unit 3128
Henrico, VA 23228-2270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904015178 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1477405561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2430 HOXTON RD UNIT 3128",
"city": "HENRICO",
"state": "VA",
"postal_code": "232282270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 24TH ST",
"city": "FORT GREGG ADAMS",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JARED",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2026-02-11",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904015178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gregg Adams, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.