Active NPI
Constance Mitchell, LPC
- Professional Counselor
- Raleigh, NC
National Provider Identifier
1669522306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3458
- Practice address
- 2112 Langdon Rd
Raleigh, NC 27604-3616 - Phone
- (919) 889-2868
- Fax
- (919) 954-7124
- NPI assigned
- Jan 12, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 3458 | NC | Primary |
Addresses
Primary practice location
2112 Langdon Rd
Raleigh, NC 27604-3616
Mailing address
2112 Langdon Rd
Raleigh, NC 27604-3616
Phone (919) 889-2868
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102601 | Medicaid | NC |
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 |
|---|---|---|---|
| 3458 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250899200000",
"number": "1669522306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 LANGDON RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276043616",
"telephone_number": "919-889-2868",
"fax_number": "919-954-7124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 LANGDON RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276043616",
"telephone_number": "919-889-2868",
"fax_number": "919-954-7124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "CONSTANCE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2009-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "3458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6102601",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.