Individual provider Active NPI

Phillip B Mitchell II, LCSW

  • Clinical Social Worker
  • Terre Haute, IN
National Provider Identifier
1598356099
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009111A Issued in IN
Practice address
500 8TH Ave
Terre Haute, IN 47804-4072
Phone
(812) 231-8376
Fax
(812) 231-8208
NPI assigned
Jan 28, 2021
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34009111A IN Primary

Addresses

Primary practice location

500 8TH Ave
Terre Haute, IN 47804-4072

Mailing address

620 8TH Ave
Terre Haute, IN 47804-2771
Phone (812) 231-8323

Other practice location 1

950 N Meridian St
Indianapolis, IN 46204-1077
Phone (317) 963-2200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmitchell@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210302001694 IN Practitioner - Clinical Social Worker 6901212786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34009111AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Clinical CurrentSince Jul 1, 2024 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince May 17, 2024 Accepting new patients
Hamilton Center, Inc. PastSince Jan 31, 2021 Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

950 N Meridian St
Indianapolis, IN 46204
Phone (317) 963-2200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1598356099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042771",
            "telephone_number": "812-231-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044072",
            "telephone_number": "812-231-8376",
            "fax_number": "812-231-8208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462041077",
            "country_code": "US",
            "telephone_number": "317-963-2200",
            "fax_number": "317-963-1621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PHILLIP",
        "middle_name": "B",
        "name_suffix": "II",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009111A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmitchell@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "950 N Meridian St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462041077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.