Individual provider Active NPI

Charles Michael Mitchell, LPC

  • Professional Counselor
  • Grants Pass, OR
National Provider Identifier
1568759157
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C2287 Issued in OR
Practice address
1215 SW G St
Grants Pass, OR 97526-2544
Phone
(541) 476-2373
Fax
(541) 476-1526
NPI assigned
Jul 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C2287 OR Primary

Addresses

Primary practice location

1215 SW G St
Grants Pass, OR 97526-2544

Mailing address

1590 SE N St Ste H
Grants Pass, OR 97526-3905
Phone (541) 507-7896

Other names 1

  • Charlie Mitchell Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20250708004650 OR Practitioner - Mental Health Counselor 5193239523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Options for Southern OregonGroup PAC ID 0941202006, 70 clinicians

Practice addresses (Care Compare)

1545 Harbeck Rd
Grants Pass, OR 97527-5605
Phone (541) 476-2373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Options for Southern Oregon CurrentSince Apr 25, 2025 Accepting new patients
Options for Southern Oregon CurrentSince Apr 25, 2025 Accepting new patients

Locations

1215 SW G St
Grants Pass, OR 97526
Phone (541) 244-4109

1545 Harbeck Rd
Grants Pass, OR 97527
Phone (541) 479-2371

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1568759157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 SE N ST STE H",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975263905",
            "telephone_number": "541-507-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373",
            "fax_number": "541-476-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLIE",
            "last_name": "MITCHELL",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.