MEDICARE: MS. LINDA P MITCHELL MS LMHC

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	6693	FL

General Provider Information

NPI Number	:	1932163821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA P MITCHELL MS LMHC

Provider Business Mailing Address
First Line	:	1886 BRANCHWATER TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-8510
Country	:	US
Telephone Number	:	407-382-8353
Fax Number	:	407-384-2242

Provider Business Practice Location Address
First Line	:	13000 AVALON LAKE DR
Second Line	:	SUITE 304
City	:	ORLANDO
State	:	FL
Zip	:	32828-6434
Country	:	US
Telephone Number	:	407-529-6299
Fax Number	:	407-384-2242

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	07/08/2007

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