Charles Mitchell, LCDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDP00719 Issued in RI

Practice address

10 Dorrance St Ste 700
Providence, RI 02903-2014

Phone

(800) 892-2695

NPI assigned

Aug 7, 2017

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1689199143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 CAMINO DIABLO STE 105",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973945",
            "telephone_number": "800-892-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DORRANCE ST STE 700",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032014",
            "telephone_number": "800-892-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHARLES",
        "credential": "LCDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP00719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April G. Mishley, OD
• Aman Mishra, M.D.
• Ashish Misri, M.D.
• Andrea Grace Mitchell Sr., MSPT
• Brenda Mitchell, PSYD
• Christine Mitchell, RN
• David William Mitchell, M.S., CCC-SLP
• Deloris Mitchell, PHD, IMH-E
• Denise Mitchell, LICSW
• Erica Mitchell, LICSW

• Addiction (Substance Use Disorder) Counselor in Providence, RI
• Providers in Providence, RI by specialty
• Addiction (Substance Use Disorder) Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.