Individual provider Active NPI

Leatta Ann Mitchell, LCSW

  • Clinical Social Worker
  • Rosharon, TX
National Provider Identifier
1477611879
Registry record updated Nov 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
36489 Issued in TX
Practice address
4934 Applewood Crest LN
Rosharon, TX 77583-1079
Phone
(409) 658-6810
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 36489 TX Primary

Addresses

Primary practice location

4934 Applewood Crest LN
Rosharon, TX 77583-1079

Mailing address

2623 Skyview Shadows CT
Houston, TX 77047-8113
Phone (713) 434-2389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000392 TX Practitioner - Clinical Social Worker 8426158064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36489TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
On Site Counseling,Inc. Clinical CurrentSince Aug 1, 2017 Accepting new patients
Better-Way Counseling Services LLC Clinical CurrentSince Oct 20, 2012 Accepting new patients

Locations

3007 Caroline St
Houston, TX 77004
Phone (713) 528-2328

Organizations & group practices 2

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1477611879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 SKYVIEW SHADOWS CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770478113",
            "telephone_number": "713-434-2389",
            "fax_number": "713-463-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4934 APPLEWOOD CREST LN",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775831079",
            "telephone_number": "409-658-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LEATTA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "36489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosharon, TX

Sources for this page

Verify at the official NPI Registry.