Larry Mitchell, MA CAADC SPADA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C-00112 Issued in MI

Practice address

1960 Millbrook St SE
Grand Rapids, MI 49508-2636

Phone

(616) 633-3700

Fax

(616) 930-4640

NPI assigned

Feb 1, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Larry Mitchell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1649779927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 MILLBROOK ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495082636",
            "telephone_number": "616-633-3700",
            "fax_number": "616-930-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 MILLBROOK ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495082636",
            "telephone_number": "616-633-3700",
            "fax_number": "616-930-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LARRY",
        "credential": "MA CAADC SPADA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-00112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "MITCHELL",
            "credential": "MA. CAADC SPADA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Donald Joseph Mitchell
• Elise Mitchell
• Jade Mitchell
• Janet Mitchell, RN, WHNP
• John B Mitchell, MD
• Latrasha Yvonne Mitchell
• Lisa A Mitchell, NURSE PRACTITIONER
• Macy Mitchell
• Mary Linnea Mitchell, MSW, LMSW
• McKenzie Mitchell

• Addiction (Substance Use Disorder) Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.