Mitchell Isle, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

70650 Issued in TX

Practice address

12740 Hillcrest Rd Ste 270
Dallas, TX 75230-2086

Phone

(469) 712-5734

NPI assigned

Oct 16, 2019

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Apr 12, 2024 through Apr 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• C4 Health Group PLLC

  • Professional Counselor
  • Dallas, TX
  • NPI 1619519071
  NPD Authorized official

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1629610084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WILDWOOD PL",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750131501",
            "telephone_number": "214-564-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HILLCREST RD STE 270",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302086",
            "telephone_number": "469-712-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLE",
        "first_name": "MITCHELL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Junaid Z Islam, M.D.
• Kazi Saiful Islam
• Ridwana Faiz Islam
• Rizwana Islam, PHARM.D.
• Samiha Islam, PHD
• Ammar Qadir Ismail, AA
• Isoberry Homehealth Care Services, LLC
• Ginger Isom-Batz, M.D.
• Khriste Renee Isom, OTR
• Isp Health PLLC

• Professional Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.