Individual provider Active NPI

Mickell Lethco

  • Psychologist
  • Walnut Creek, CA
National Provider Identifier
1912350919
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33936 Issued in CA
Practice address
1910 Olympic Blvd Ste 300
Walnut Creek, CA 94596-5077
Phone
(925) 322-1231
NPI assigned
Jul 14, 2016
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 33936 CA Primary

Addresses

Primary practice location

1910 Olympic Blvd Ste 300
Walnut Creek, CA 94596-5077

Mailing address

1910 Olympic Blvd Ste 300
Walnut Creek, CA 94596-5077
Phone (925) 322-1231

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.
Opted out of Medicare
Yes, effective Jul 2, 2024 through Jul 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brain Insights Psychological Solutions PC Psychologist CurrentSince Apr 1, 2025 Accepting new patients
Morrisey Compton Educational Center, Inc. Psychologist PastSince Dec 24, 2023 Accepting new patients

Locations

1910 Olympic Blvd
Ste 300
Walnut Creek, CA 94596
Phone (214) 516-4811

1990 N California Blvd
Ste 830
Walnut Creek, CA 94596
Phone (925) 322-1261

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1912350919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 OLYMPIC BLVD STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965077",
            "telephone_number": "925-322-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 OLYMPIC BLVD STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965077",
            "telephone_number": "925-322-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETHCO",
        "first_name": "MICKELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "33936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.