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NPI Code Detail

MEDICARE: KELSEY MITCHELL

MEDICARE: KELSEY MITCHELL
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
1106H00000XMarriage & Family Therapist242792KY

General Provider Information

NPI Number : 1235785973
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY MITCHELL
Provider Business Mailing Address
First Line : 918 ORMSBY LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40242-4536
Country : US
Telephone Number : 502-327-4622
Fax Number : 502-327-4675
Provider Business Practice Location Address
First Line : 918 ORMSBY LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40242-4536
Country : US
Telephone Number : 502-327-4622
Fax Number : 502-327-4675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2019
Last Update Date : 08/16/2019

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Directions to “ KELSEY MITCHELL ” Practice Location

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