MEDICARE: JILLIAN 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
1	1041C0700X	Clinical Social Worker	21756	OK

General Provider Information

NPI Number	:	1437944121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN MITCHELL

Provider Business Mailing Address
First Line	:	PO BOX 12978
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73157-2978
Country	:	US
Telephone Number	:	405-858-2733
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 12978
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73157-2978
Country	:	US
Telephone Number	:	405-828-2700
Fax Number	:

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

Provider Enumeration Date	:	04/12/2025
Last Update Date	:	08/19/2025

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Directions to “ JILLIAN MITCHELL ” Practice Location

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