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NPI Code Detail

MEDICARE: DEBORAH MITCHELL MSW

MEDICARE: DEBORAH MITCHELL MSW
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
11041C0700XClinical Social WorkerS.0017427OH
21041C0700XClinical Social WorkerS0017427OH

General Provider Information

NPI Number : 1548611072
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH MITCHELL MSW
Provider Business Mailing Address
First Line : 222 MARION AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-2138
Country : US
Telephone Number : 567-560-3582
Fax Number : 567-560-4484
Provider Business Practice Location Address
First Line : 2775 STATE ROUTE 39
Second Line :
City : SHELBY
State : OH
Zip : 44875-9466
Country : US
Telephone Number : 419-747-3322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2016
Last Update Date : 04/30/2018

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