Individual provider Active NPI

Beverly Ann Mitchell, PAD

  • Mental Health Counselor
  • Torrance, CA
National Provider Identifier
1619082963
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PSY6984 Issued in CA
Practice address
24445 Hawthorne Blvd
Suite 211
Torrance, CA 90505
Phone
(310) 373-1486
Fax
(310) 373-3213
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PSY6984 CA Primary

Addresses

Primary practice location

24445 Hawthorne Blvd
Suite 211
Torrance, CA 90505

Mailing address

24445 Hawthorne Blvd
Suite 211
Torrance, CA 90505
Phone (310) 373-1486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2016 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY6984CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619082963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24445 HAWTHORNE BLVD",
            "address_2": "SUITE 211",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90505",
            "telephone_number": "310-373-1486",
            "fax_number": "310-373-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24445 HAWTHORNE BLVD",
            "address_2": "SUITE 211",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90505",
            "telephone_number": "310-373-1486",
            "fax_number": "310-373-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY6984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.