Individual provider Active NPI

Daniel Robert Mitchell, PH.D

  • Counseling Psychologist
  • Montpelier, VT
National Provider Identifier
1982869111
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
048.0058348 Issued in VT
Practice address
156 Main St
Montpelier, VT 05602-2702
Phone
(802) 223-4738
Fax
(802) 223-6067
NPI assigned
Jul 28, 2008
Last updated
Mar 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 004067 NY
Counseling Psychologist 103TC1900X 048.0058348 VT Primary

Addresses

Primary practice location

156 Main St
Montpelier, VT 05602-2702

Mailing address

PO Box 547
Att: CVMC Finance Dept
Barre, VT 05641-0547
Phone (802) 223-4738

Other identifiers 1

IdentifierTypeStateIssuer
1024491MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150511001089 VT Practitioner - Clinical Psychologist 1355574864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

156 Main St
Montpelier, VT 05602-2702
Phone (802) 223-4738

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004067NYMDInternal Medicine Physician
018459NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc CurrentSince May 25, 2015 Accepting new patients

Locations

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

156 Main St
Montpelier, VT 05602
Phone (802) 223-4738

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1982869111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-223-4738",
            "fax_number": "802-223-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 MAIN ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056022702",
            "telephone_number": "802-223-4738",
            "fax_number": "802-223-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004067",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VT",
            "license": "048.0058348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024491",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, VT

Sources for this page

Verify at the official NPI Registry.