Bernard Eugene Mitchell Jr., MSW, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P020448 Issued in NC

Practice address

3925 N Duke St Ste 123
Durham, NC 27704-1780

Phone

(919) 680-8833

NPI assigned

Oct 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1487317087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 WEAVER RD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278937968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N DUKE ST STE 123",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277041780",
            "telephone_number": "919-680-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BERNARD",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P020448",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miss Ruby'S Place
• Amy Wilkov Mistarz
• Amy Kraft Mistler, PH.D.
• Ariel Mitchell
• Audrey Grace Mitchell
• Charles Mitchell
• John T Mitchell, PHD
• Joshua Thomas Mitchell
• Kalie Brooke Mitchell
• Kara Mitchell, MS,RD/LDN,ACSM-RCEP

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.