Healthcare Provider Details

I. General information

NPI: 1750950325
Provider Name (Legal Business Name): KATHRYN MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14635 S HARRELLS FERRY RD STE 3A
BATON ROUGE LA
70816-2960
US

IV. Provider business mailing address

14758 STONEBERG AVE
BATON ROUGE LA
70816-7206
US

V. Phone/Fax

Practice location:
  • Phone: 225-349-8984
  • Fax:
Mailing address:
  • Phone: 504-498-6487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number20011
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: