Active NPI
Mitchel Daniels
- Mental Health Counselor
- Harrisburg, IL
National Provider Identifier
1831801638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 110 Williams Dr
Harrisburg, IL 62946-3783 - Phone
- (618) 499-4881
- NPI assigned
- Dec 23, 2022
- Last updated
- Dec 23, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IL | Primary |
Addresses
Primary practice location
110 Williams Dr
Harrisburg, IL 62946-3783
Mailing address
110 Williams Dr
Harrisburg, IL 62946-3783
Phone (618) 499-4881
Other practice location 1
626 W Oakdale Ave
Chicago, IL 60657-5310
Phone (618) 499-4881
Other practice location 2
90 State St Apt 1112
Albany, NY 12207-1703
Phone (618) 499-4881
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.sanford.html |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1831801638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WILLIAMS DR",
"city": "HARRISBURG",
"state": "IL",
"postal_code": "629463783",
"telephone_number": "618-499-4881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 WILLIAMS DR",
"city": "HARRISBURG",
"state": "IL",
"postal_code": "629463783",
"telephone_number": "618-499-4881"
}
],
"practiceLocations": [
{
"address_1": "626 W Oakdale Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575310",
"country_code": "US",
"telephone_number": "618-499-4881",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "90 State St Apt 1112",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122071703",
"country_code": "US",
"telephone_number": "618-499-4881",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DANIELS",
"first_name": "MITCHEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-12-23",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.sanford.html",
"affiliation": "N",
"address_1": "626 W Oakdale Ave",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606575310",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Harrisburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.