Healthcare Provider Details

I. General information

NPI: 1013655174
Provider Name (Legal Business Name): HANNAH MITCHELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MDG UNIT 5115
APO AE
09461
US

IV. Provider business mailing address

48 MDG/SGXWF BOX 15
LAKENHEATH BRANDON SUFFOLK
IP27 9PN
GB

V. Phone/Fax

Practice location:
  • Phone: 314-226-8070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number105415
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: