NPIMap

Organization Active NPI

Chante Wellington Mitchell, PH.D., LLC

  • Clinical Psychologist
  • Duluth, GA
National Provider Identifier
1831865674
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CHANTE WELLINGTON MITCHELL, PH.D., LLC
Practice address
2400 Pleasant Hill Rd Ste 165
Duluth, GA 30096-1702
Phone
(770) 476-1967
Fax
(770) 476-0377
NPI assigned
Aug 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Authorized official

Name
Dr. Chante Wellington Mitchell, PH.D.
Title
Owner/Provider
Phone
(770) 476-0377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2400 Pleasant Hill Rd Ste 165
Duluth, GA 30096-1702

Mailing address

2400 Pleasant Hill Rd Ste 165
Duluth, GA 30096-1702
Phone (770) 476-1967

National Provider Directory

National Provider Directory

Locations

2400 Pleasant Hill Rd
Ste 165
Duluth, GA 30096
Phone (770) 476-1967

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1831865674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 PLEASANT HILL RD STE 165",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961702",
            "telephone_number": "770-476-1967",
            "fax_number": "770-476-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PLEASANT HILL RD STE 165",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961702",
            "telephone_number": "770-476-1967",
            "fax_number": "770-476-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTE WELLINGTON MITCHELL, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHANTE",
        "authorized_official_middle_name": "WELLINGTON",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "770-476-0377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.