Individual provider Active NPI

Jon Mitchell, LPCC

  • Professional Counselor
  • Lexington, KY
National Provider Identifier
1710431671
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
243809 Issued in KY
Practice address
1353 W Main St
Lexington, KY 40508-2065
Phone
(855) 591-0092
NPI assigned
Aug 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 243809 KY Primary

Addresses

Primary practice location

1353 W Main St
Lexington, KY 40508-2065

Mailing address

3175 Custer Dr Ste 303
Lexington, KY 40517-4023
Phone (859) 312-4484

Other practice location 1

3439 Buckhorn Dr
Lexington, KY 40515-1716
Phone (859) 595-2081

Other practice location 2

3175 Custer Dr Ste 303
Lexington, KY 40517-4023
Phone (859) 312-4484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240320003878 KY Practitioner - Mental Health Counselor 2264883099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3175 Custer Dr
Suite 303
Lexington, KY 40517-4023
Phone (502) 783-7575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
243809KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Mitchell, LLC Professional CurrentSince Dec 2, 2023 Accepting new patients
Kentucky Counseling Center, LLC Professional PastSince Oct 1, 2019 Accepting new patients

Locations

3175 Custer Dr
Ste 303
Lexington, KY 40517
Phone (502) 783-7575

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1710431671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 CUSTER DR STE 303",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174023",
            "telephone_number": "859-312-4484",
            "fax_number": "502-631-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 W MAIN ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405082065",
            "telephone_number": "855-591-0092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3439 Buckhorn Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405151716",
            "country_code": "US",
            "telephone_number": "859-595-2081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3175 Custer Dr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405174023",
            "country_code": "US",
            "telephone_number": "859-312-4484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JON",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "243809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.