MRS. KIRSTEN L MITCHELL (PSYD) – Clinical Psychologist, NPI 1053460634

MRS. KIRSTEN L MITCHELL (PSYD) is a healthcare provider. based in Kankakee, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 071007177 (IL). The NPI Number for MRS. KIRSTEN L MITCHELL (PSYD) is 1053460634

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIRSTEN L MITCHELL (PSYD)
NPI
1053460634
Phone
(815) 935-0750
Address
375 N WALL ST STE P510
Enumeration Date
10 January 2007
Last Update Date
9 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8152779906
Graduation Year
2005 (21 years ago)
PAC ID
1557363587
Group Practice PAC ID
5496133662
Professional Enrollment ID
I20070205000392
Address ID
IL604514834NE2081XDRXX301

Contacts

Secure Messaging
kmitchell8336@Direct.riversidehealthcare.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for MRS. KIRSTEN L MITCHELL (PSYD)

  • 375 N WALL ST STE P510

    KANKAKEE, IL 609013492

    Phone: (815) 935-0750

    Fax: (815) 935-8797

    Type: Mailing

  • 2081 CALISTOGA DR

    NEW LENOX, IL 604514831

    Phone: (815) 277-9906

    Fax: (815) 277-9907

    Type: Mailing

  • 2081 CALISTOGA DR STE 3N

    NEW LENOX, IL 604514834

    Phone: (815) 277-9906

    Fax: (815) 277-9907

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-02-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070205000392IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96137Administration of psychological or neuropsychological test, each additional 30 minutes17950$0
96133Evaluation of neuropsychological test, each additional hour17350$0
96116Exam of neurobehavioral status, first hour5050$0
96132Evaluation of neuropsychological test, first hour5050$0
96136Administration of psychological or neuropsychological test, first 30 minutes5050$0
View full utilization report →

Insurance plans in this area (ZIP 60901)

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Provider's Procedures

MRS. KIRSTEN L MITCHELL (PSYD) performs procedures in CLINICAL PSYCHOLOGIST. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHOLOGIST, CLINICALIL96118Neuropsychological testing, interpretation, and report by psychologist or physician per hour12377

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496133662View full group profile
NameSpecialtyState
Clinical PsychologistIL

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Frequently asked questions

How do I look up MRS. KIRSTEN L MITCHELL (PSYD) by NPI?
Use NPI 1053460634 when you need to reference MRS. KIRSTEN L MITCHELL (PSYD) in forms, claims, or directories.
Is MRS. KIRSTEN L MITCHELL (PSYD)'s NPI currently valid?
The extract we use shows MRS. KIRSTEN L MITCHELL (PSYD) as active.
Can you summarize MRS. KIRSTEN L MITCHELL (PSYD)'s specialty in plain language?
Clinically, the directory lists MRS. KIRSTEN L MITCHELL (PSYD) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does MRS. KIRSTEN L MITCHELL (PSYD) practice in Illinois?
You will see Kankakee, Illinois on file for MRS. KIRSTEN L MITCHELL (PSYD) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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