Healthcare Provider Details

I. General information

NPI: 1205359528
Provider Name (Legal Business Name): AR MITCHELL CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 GREENCOVE CT
NEWNAN GA
30265-3391
US

IV. Provider business mailing address

90-F GLENDA TRACE #306
NEWNAN GA
30265-3391
US

V. Phone/Fax

Practice location:
  • Phone: 334-782-2743
  • Fax:
Mailing address:
  • Phone: 762-499-7823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AISHA R MITCHELL WASHINGTON
Title or Position: OWNER
Credential: MS, C-ASWCM, LCSW
Phone: 334-782-2743