Active NPI
Laura Thompson Mitchell, LSW
- Social Worker
- Montclair, NJ
National Provider Identifier
1699097162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05779600
- Practice address
- 1 Bay Ave
Montclair, NJ 07042-4837 - Phone
- (973) 429-6141
- NPI assigned
- Feb 24, 2010
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 73 081118 | NY | |
| Social Worker | 104100000X | 44SL05779600 | NJ | Primary |
Addresses
Primary practice location
1 Bay Ave
Montclair, NJ 07042-4837
Mailing address
127 Midland Ave
#2
Montclair, NJ 07042-2959
Phone (718) 344-2665
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 |
|---|---|---|---|
| 44SL05779600 | NJ | MD | Social Worker |
| 73 081118 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384128000000",
"number": "1699097162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 MIDLAND AVE",
"address_2": "#2",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422959",
"telephone_number": "718-344-2665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BAY AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070424837",
"telephone_number": "973-429-6141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "LAURA",
"middle_name": "THOMPSON",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-24",
"last_updated": "2013-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "73 081118",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05779600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.