Healthcare Provider Details

I. General information

NPI: 1740143007
Provider Name (Legal Business Name): AIESHA MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SOUTHERN AVE SE APT 1221
WASHINGTON DC
20032-4837
US

IV. Provider business mailing address

800 SOUTHERN AVE SE APT 1221
WASHINGTON DC
20032-4837
US

V. Phone/Fax

Practice location:
  • Phone: 202-607-8096
  • Fax: 202-607-8096
Mailing address:
  • Phone: 202-607-8096
  • Fax: 202-607-8096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200003151
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: