Individual provider Active NPI

Deborah Mitchell

  • Social Worker
  • Detroit, MI
National Provider Identifier
1760640254
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6803086683 Issued in MI
Practice address
19940 Conant St Ste Abc
Detroit, MI 48234-1494
Phone
(313) 733-4528
Fax
(313) 733-4532
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Social Worker 104100000X 6803086683 MI Primary

Addresses

Primary practice location

19940 Conant St Ste Abc
Detroit, MI 48234-1494

Mailing address

19345 Patton St
Detroit, MI 48219-2530
Phone (313) 742-6016

Other practice location 1

19345 Patton St
Detroit, MI 48219-2530
Phone (313) 742-6016

Other practice location 2

17195 Meyers Rd
Detroit, MI 48235-1414
Phone (313) 742-6016

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

LicenseStateTypeSpecialty
6803086683MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Recovery and Rehabilitation Consultants, LLC CurrentSince Oct 23, 2022 Accepting new patients
Institute of Supportive Services, Inc. Addiction (Substance Use Disorder) Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1760640254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19345 PATTON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192530",
            "telephone_number": "313-742-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19940 CONANT ST STE ABC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341494",
            "telephone_number": "313-733-4528",
            "fax_number": "313-733-4532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19345 Patton St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482192530",
            "country_code": "US",
            "telephone_number": "313-742-6016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17195 Meyers Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482351414",
            "country_code": "US",
            "telephone_number": "313-742-6016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DEBORAH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6803086683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.