Penni Mitchell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW10422 Issued in FL

Practice address

3823 E State Road 64
Bradenton, FL 34208-9041

Phone

(941) 745-5111

Fax

(941) 745-5667

NPI assigned

Mar 20, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1578838892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 BURGOS DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342382702",
            "telephone_number": "401-368-0990",
            "fax_number": "941-745-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342089041",
            "telephone_number": "941-745-5111",
            "fax_number": "941-745-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PENNI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashminie Persaud Misir, MD, MS
• Ronda Sue Mitchell-Cosgrove, MSW, LCSW
• Amanda Mitchell, D.C.
• Cassandra Renee Mitchell, LMHC
• Gwendolyn Mitchell, MASSAGE THERAPIST
• Samuel Justin Mitchell, CHIROPRACTOR
• Tammy Mitchell, BA SLP-A
• Lakia Foster Mobley
• Modern Movement Physical Therapy, PLLC
• Heidi Moen, BS

• Clinical Social Worker in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.