Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mitchell Lee Gresham Jr.

Individual provider Professional Counselor · NPI 1437622883

Mr. Mitchell Lee Gresham Jr. is a Mental Health Counselor in San Diego, California. Qualified in 2016, 10 years ago. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2019
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Practice location Address checks out

4660 Palm Ave
San Diego, CA 92154-8404
Phone: (183) 357-9484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 21573 (CA)

Record details

NPI number1437622883
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 8, 2019
Last updated in NPPESJune 19, 2026
Certification dateJune 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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