Susan Anne Mitchell, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106981 Issued in MA

Practice address

222 Milliken Blvd
Center for Behavioral Medicine
Fall River, MA 02721-1623

Phone

(508) 674-7000

Fax

(508) 678-6330

NPI assigned

Sep 5, 2007

Sex

Female

Sole proprietor

Yes

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1710171459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DEER RUN",
            "city": "MATTAPOISETT",
            "state": "MA",
            "postal_code": "027391243",
            "telephone_number": "508-758-3645",
            "fax_number": "508-678-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MILLIKEN BLVD",
            "address_2": "CENTER FOR BEHAVIORAL MEDICINE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027211623",
            "telephone_number": "508-674-7000",
            "fax_number": "508-678-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SUSAN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hany Mistikawy, M.D.
• Brian J Mitchell, LICSW
• Chryssa Marie Mitchell
• Grace M. Mitchell
• John R Mitchell, LICSW
• Jessica Mkpanam, MSW
• Mikyong Mobilia, CPNP-PC
• Modern Dermatology of Massachusetts, PLLC
• Elisabeth Karen Modestino, LICSW
• Elizabeth Modiclan

• Clinical Social Worker in Fall River, MA
• Providers in Fall River, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.