MEDICARE: MRS. CANDICE LOUISE 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	101YM0800X	Mental Health Counselor	CP3351	NV

General Provider Information

NPI Number	:	1578862538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CANDICE LOUISE MITCHELL

Provider Business Mailing Address
First Line	:	921 S. HWY 160, ST. 203
Second Line	:	ST. 203
City	:	PAHRUMP
State	:	NV
Zip	:	89048
Country	:	US
Telephone Number	:	775-419-6838
Fax Number	:	775-204-1611

Provider Business Practice Location Address
First Line	:	921 S. HWY 160, ST. 203
Second Line	:	ST. 203
City	:	PAHRUMP
State	:	NV
Zip	:	89048
Country	:	US
Telephone Number	:	775-419-6838
Fax Number	:	775-204-1611

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

Provider Enumeration Date	:	03/16/2011
Last Update Date	:	05/05/2026

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