Healthcare Provider Details

I. General information

NPI: 1740199330
Provider Name (Legal Business Name): MRS. ANEISHA MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5887 GLENRIDGE DR STE 230
SANDY SPRINGS GA
30328-9929
US

IV. Provider business mailing address

15147 SPIDER LILY RD
FRISCO TX
75035-1192
US

V. Phone/Fax

Practice location:
  • Phone: 404-585-1910
  • Fax:
Mailing address:
  • Phone: 214-926-2195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC016870
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: