Michelle D. Mitchell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002833 Issued in GA

Practice address

3480 Greenbriar Pkwy SW Ste 230
Atlanta, GA 30331-3123

Phone

(404) 516-1996

Fax

(678) 309-3730

NPI assigned

May 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1922213974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725575",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311392575",
            "telephone_number": "404-516-1996",
            "fax_number": "678-309-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 GREENBRIAR PKWY SW STE 230",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303313123",
            "telephone_number": "404-516-1996",
            "fax_number": "678-309-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MICHELLE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PRACTITIONER #",
            "identifier": "10044615",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesley Nicole Mitchell, LCSW
• Lisa Ashiya Mitchell, LPN
• Madison Mitchell
• Marguerite Lucy Mitchell
• Michael Rickey Mitchell, LMFT
• Minnie Ihbriem Mitchell
• Monique Elise Mitchell
• Patricia Ann Mitchell, HIS
• Paul G Mitchell, M.D.
• Rachel Leigh Mitchell, APRN

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.