Active NPI
Mitchell Alonzo Harrell
- Social Worker
- Chico, CA
National Provider Identifier
1538866520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW104648
- Practice address
- 1601 Concord Ave # Butte120
Chico, CA 95928-9487 - Phone
- (530) 219-0284
- Fax
- (530) 879-5012
- NPI assigned
- Feb 10, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW104648 | CA | Primary |
Addresses
Primary practice location
1601 Concord Ave # Butte120
Chico, CA 95928-9487
Mailing address
1601 Concord Ave # Butte120
Chico, CA 95928-9487
Phone (530) 219-0284
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 |
|---|---|---|---|
| ASW104648 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1538866520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 CONCORD AVE # BUTTE120",
"city": "CHICO",
"state": "CA",
"postal_code": "959289487",
"telephone_number": "530-219-0284",
"fax_number": "530-879-5012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 CONCORD AVE # BUTTE120",
"city": "CHICO",
"state": "CA",
"postal_code": "959289487",
"telephone_number": "530-219-0284",
"fax_number": "530-879-5012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "MITCHELL",
"middle_name": "ALONZO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-10",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW104648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.