Active NPI
Joan Mitchell, ST
- Speech-Language Pathologist
- Andalusia, AL
National Provider Identifier
1609935170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1072
- Practice address
- 512 E Three Notch St
Andalusia, AL 36420-3128 - Phone
- (334) 222-2102
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1072 | AL | Primary |
Addresses
Primary practice location
512 E Three Notch St
Andalusia, AL 36420-3128
Mailing address
111 Ridgecrest Dr
Andalusia, AL 36421-4226
Phone (334) 222-8463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1072 | Other | AL | SLP LICENSE |
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 |
|---|---|---|---|
| 1072 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609935170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 RIDGECREST DR",
"city": "ANDALUSIA",
"state": "AL",
"postal_code": "364214226",
"telephone_number": "334-222-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 E THREE NOTCH ST",
"city": "ANDALUSIA",
"state": "AL",
"postal_code": "364203128",
"telephone_number": "334-222-2102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JOAN",
"credential": "ST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "1072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SLP LICENSE",
"identifier": "1072",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Andalusia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.