Andrea M Mitchell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

66539 Issued in TX

Practice address

4404 Leisure Time Dr
Diamondhead, MS 39525-3237

Phone

(281) 687-3322

NPI assigned

Jan 16, 2011

Sex

Female

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

Enrolled in MS

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Safe Harbor Clinic LLCGroup PAC ID 1759615693, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Safe Harbor Clinic LLC

  • Psychiatry Physician
  • Long Beach, MS
  • NPI 1699242891

  MS

  Medicare reassignment Care Compare group NPD
• Champions Christian Counseling Center L.L.C

  • Professional Counselor
  • Tomball, TX
  • NPI 1952519332

  Professional

  NPD (past)

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

{
    "created_epoch": "1295136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1497050835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 HANAKEALOHA PL",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253004",
            "telephone_number": "281-687-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 LEISURE TIME DR",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253237",
            "telephone_number": "281-687-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-16",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "66539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Memorial Hospital at Gulfport
• Memorial Hospital at Gulfport
• Ronald Boa Miller Jr., N.P.
• Elizabeth Milner, DPT
• Mississippi CVS Pharmacy, LLC
• Mmemorial Hospital at Gulfport
• Susan H Niemann, PHD, LPC
• Stewart Allen Nutting, M.D.
• Ochsner Mississippi, LLC
• Ochsner Mississippi, LLC

• All providers in Diamondhead, MS
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.