Individual provider Active NPI

Ebony Mitchell

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1851884720
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1020 Woodman Dr Ste 330
Dayton, OH 45432-1410
Phone
(937) 253-0606
Fax
(877) 938-3265
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X
Social Worker 104100000X
Clinical Social Worker 1041C0700X Primary
Student in an Organized Health Care Education/Training Program 390200000X
School Social Worker 1041S0200X W.2000226 OH

Addresses

Primary practice location

1020 Woodman Dr Ste 330
Dayton, OH 45432-1410

Mailing address

2611 Wayne Ave
Dayton, OH 45420-1833
Phone (937) 641-8554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1020 Woodman Dr
Suite 300
Dayton, OH 45432-1410
Phone (937) 253-0606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
W.2000226OHMDSchool Social Worker

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1851884720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 WAYNE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201833",
            "telephone_number": "937-641-8554",
            "fax_number": "877-938-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR STE 330",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321410",
            "telephone_number": "937-253-0606",
            "fax_number": "877-938-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "EBONY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OH",
            "license": "W.2000226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.