Colleen D Mitchell, PHD, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05644 Issued in MD

Legal business name

COLLEEN D MITCHELL, PHD, LLC

Practice address

8101 Sandy Spring Rd
Suite 100F
Laurel, MD 20707-3596

Phone

(951) 536-3682

NPI assigned

Jan 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Colleen Denise Mitchell, PHDNPI 1184751604

Title

Licensed Clinical Psychologist

Phone

(951) 536-3682

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colleen Denise Mitchell, PH.D.

  • Clinical Psychologist
  • Laurel, MD
  • NPI 1184751604

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1730547266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 TURBRIDGE DR",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208662009",
            "telephone_number": "951-536-3682",
            "fax_number": "301-890-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 SANDY SPRING RD",
            "address_2": "SUITE 100F",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073596",
            "telephone_number": "951-536-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEEN D MITCHELL, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "951-536-3682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Cole
• Teal Cole, LPC
• Ana-Aelice Coleman
• Stephen Collalto
• Cody Nicole Collazo, CRNP-PEDIATRICS
• Raeleena Collington, EDD, MBA, MS, LN
• Kiana R Collins, LMSW
• Emily Colon
• Chandra Colvin, LICSW
• Darlene Deniese Combs

• Clinical Psychologist in Laurel, MD
• Providers in Laurel, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.