Active NPI
Mary Mitchell, L.C.S.W.
- Clinical Social Worker
- Carmel, NY
National Provider Identifier
1750393120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R019657-1
- Practice address
- 667 Stoneleigh Ave
Suite 202
Carmel, NY 10512-2454 - Phone
- (845) 279-5908
- Fax
- (845) 279-5447
- NPI assigned
- Aug 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R019657-1 | NY | Primary |
Addresses
Primary practice location
667 Stoneleigh Ave
Suite 202
Carmel, NY 10512-2454
Mailing address
667 Stoneleigh Ave
Suite 202
Carmel, NY 10512-2454
Phone (845) 279-5908
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R019657-1 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carmel Psychological Health, PC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222214400000",
"number": "1750393120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "667 STONELEIGH AVE",
"address_2": "SUITE 202",
"city": "CARMEL",
"state": "NY",
"postal_code": "105122454",
"telephone_number": "845-279-5908",
"fax_number": "845-279-5447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "667 STONELEIGH AVE",
"address_2": "SUITE 202",
"city": "CARMEL",
"state": "NY",
"postal_code": "105122454",
"telephone_number": "845-279-5908",
"fax_number": "845-279-5447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "MARY",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-13",
"last_updated": "2008-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R019657-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.