Healthcare Provider Details

I. General information

NPI: 1609229210
Provider Name (Legal Business Name): KELSEY JEAN MITCHELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 IRON POINT RD STE 210
FOLSOM CA
95630-8713
US

IV. Provider business mailing address

2365 IRON POINT RD STE 210
FOLSOM CA
95630-8713
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax: 415-296-5299
Mailing address:
  • Phone: 279-258-6718
  • Fax: 916-596-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: