DEIDRA ANN MITCHELL
NPI 1760097588
Social Worker - Clinical in Granville, NY
About Deidra Ann Mitchell NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEIDRA ANN MITCHELL (NPI 1760097588) is an individual clinical provider in Granville, New York and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Deidra Ann Mitchell is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Deidra Mitchell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Queensbury, NY 12804
- Reassigned Medicare billing, New York enrollment
- 107 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 12832 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRANVILLE, NY 12832
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 Deidra Mitchell's NPI number?
The NPI number for Deidra Mitchell is 1760097588. It was assigned to this individual provider in the NPPES registry on September 9, 2020.
Where is Deidra Mitchell located?
Deidra Mitchell practices at 58 Quaker St, Granville, NY 12832. The listed phone number is (518) 642-1051.
What is Deidra Mitchell's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Deidra Mitchell enrolled in Medicare?
Yes. Deidra Mitchell is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Deidra Mitchell's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Deidra Mitchell reassigns Medicare benefits to Behavioral Health Services North, Inc. (Queensbury, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Deidra Mitchell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Deidra Mitchell was last updated on September 9, 2020. 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.
# Deidra Ann Mitchell · NPI 1760097588
Clinical provider in Granville, New York. Individual provider, active in the CMS NPPES registry since September 9, 2020.
## Identity
- **NPI:** 1760097588 (Entity type: Individual)
- **Enumerated:** September 9, 2020
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 58 QUAKER ST, Granville, NY 12832-1513
- **Phone:** (518) 642-1051
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Behavioral Health Services North, Inc. (NPI 1447005541, Queensbury, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** September 9, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1760097588) · Data from the CMS NPPES public registry.