MITCHELL ISLE LPC
NPI 1629610084
Counselor - Professional in Dallas, TX
About Mitchell Isle Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MITCHELL ISLE LPC (NPI 1629610084) is an individual professional provider in Dallas, Texas, licensed in Texas (70650) and active in the NPI registry since October 2019. He has opted out of Medicare through April 12, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mitchell Isle Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 12, 2024 through April 12, 2028.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DALLAS, TX 75230
DALLAS, TX 75230
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mitchell Isle's NPI number?
The NPI number for Mitchell Isle is 1629610084. It was assigned to this individual provider in the NPPES registry on October 16, 2019.
Where is Mitchell Isle located?
Mitchell Isle practices at 12740 Hillcrest Rd Ste 270, Dallas, TX 75230. The listed phone number is (469) 712-5734.
What is Mitchell Isle's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Mitchell Isle enrolled in Medicare?
No. Mitchell Isle has opted out of Medicare through April 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Mitchell Isle was last updated on October 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mitchell Isle, LPC · NPI 1629610084
Professional provider in Dallas, Texas. Individual provider, active in the CMS NPPES registry since October 16, 2019.
## Identity
- **NPI:** 1629610084 (Entity type: Individual)
- **Enumerated:** October 16, 2019
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 70650 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 12740 HILLCREST RD STE 270, Dallas, TX 75230-2086
- **Phone:** (469) 712-5734
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 12, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** October 16, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1629610084) · Data from the CMS NPPES public registry.