Healthcare Provider Details

I. General information

NPI: 1578992236
Provider Name (Legal Business Name): CHELSEA MARIE MITCHELL M.S.ED/CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 LONG BEACH BLVD STE 700
LONG BEACH CA
90807-2000
US

IV. Provider business mailing address

2124 NE 123RD ST SUITE 210
NORTH MIAMI FL
33181-2881
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 305-895-0444
  • Fax: 305-895-0490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.14739
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: