MEDICARE: LEAH MITCHELL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW66537	CA

General Provider Information

NPI Number	:	1184812307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH MITCHELL LCSW

Provider Business Mailing Address
First Line	:	8697 LA MESA BLVD
Second Line	:	SUITE C #151
City	:	LA MESA
State	:	CA
Zip	:	91942
Country	:	US
Telephone Number	:	619-289-7835
Fax Number	:	619-463-9824

Provider Business Practice Location Address
First Line	:	4730 PALM AVE STE 212
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5244
Country	:	US
Telephone Number	:	619-289-7835
Fax Number	:	619-463-9824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	05/15/2026

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