JESSICA DIANE MITCHELL PH.D.
NPI 1447508791
Psychologist - Clinical Child & Adolescent in Canandaigua, NY

NPI Status: Active since August 16, 2012

Contact Information

3019 COUNTY COMPLEX DR
CANANDAIGUA, NY
ZIP 14424
Phone: (585) 396-4363

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  • Individual
  • Female
  • Years of Experience 15
  • Psychologist
  • Clinical Child & Adolescent
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JESSICA MITCHELL

This page provides the complete NPI Profile along with additional information for Jessica Mitchell, a provider established in Canandaigua, New York with a medical specialization in Psychologist, focusing in clinical child & adolescent and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1447508791 assigned on August 2012. The practitioner's primary taxonomy code is 103TC2200X. The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI
1447508791
Provider Name
JESSICA DIANE MITCHELL PH.D.
Gender
Female
Entity Type
Individual
Location Address
3019 COUNTY COMPLEX DR CANANDAIGUA, NY 14424
Location Phone
(585) 396-4363
Mailing Address
2083 COUNTY ROAD 25 PHELPS, NY 14532
Mailing Phone
(401) 243-7154
Medical School Name
OTHER
Graduation Year
2011
Is Sole Proprietor?
Yes
Enumeration Date
08-16-2012
Last Update Date
06-05-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist Clinical Child & Adolescent

Taxonomy Code
103TC2200X
Type
Behavioral Health & Social Service Providers
Taxonomy Description
A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Medicare Participation & PECOS Enrollment Status

Jessica Mitchell is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jessica Mitchell is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7719113901

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20131118000734

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1447508791
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
248710016718
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 8 + 7 + 1 + 0 + 0 + 1 + 6 + 7 + 1 + 8 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1447508791 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1205834801ONTARIO COUNTY COUNTY TREAS
Organization
Home Health3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4997
1396858866 KRISTINE S CONSIGLIO LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1134232630 DIANE LYNN JOHNSTON LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1932213196 JAMES EVERETT DITMARS LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1831203025 KATHRYN A DEBRUIN LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1740394915 JULIE WILNER LMSW
Individual
Social Worker3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1346352796 WILLIAM M SWINGLY LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1366554610 ROBERT B HALL PHD
Individual
Psychologist3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1326150764 KRISTINE A BARSZEWSKI LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1861504128 JANICE CATHERINE CREAMER LCSW-R
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1194827725 JESSICA R NORTON M.D.
Individual
Psychiatry & Neurology (Psychiatry)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1164500385MRS. ANNE J. LAHR CASAC, CPP
Individual
Counselor (Addiction (Substance Use Disorder))3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190
1679651897 LORETTA A. SPRAGUE CASAC
Individual
Counselor (Addiction (Substance Use Disorder))3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190
1366520595MRS. JO ANN LANGER LMSW, CASAC-T
Individual
Social Worker (Clinical)3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190
1144308289MR. SHAFEEGH HABEEB
Individual
Counselor3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190
1750469961MS. JUNE ELIZABETH FISHER LMSW, CASAC
Individual
Counselor (Addiction (Substance Use Disorder))3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190
1720167075 BARBARA S BAYLEY BA, CASAC
Individual
Counselor (Addiction (Substance Use Disorder))3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190
1932365624MR. JEREMY D MACALUSO LMSW
Individual
Social Worker3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1699910828DR. EHRIN E LOVRIA PH.D.
Individual
Psychologist3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4363
1386889087MS. BETSEY H LEE LMSW, CASAC
Individual
Counselor (Addiction (Substance Use Disorder))3019 COUNTY COMPLEX DR
CANANDAIGUA, NY 14424
(585) 396-4190

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447508791, enumerated in the NPI registry as an "individual" on August 16, 2012

The provider is located at 3019 County Complex Dr Canandaigua, Ny 14424 and the phone number is (585) 396-4363

The provider's speciality is Psychologist with taxonomy code 103TC2200X with a focus in Clinical Child & Adolescent

The provider has more than 15 years of experience.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

This NPI record was last updated on August 16, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.