Healthcare Provider Details

I. General information

NPI: 1609667229
Provider Name (Legal Business Name): VEETA W MITCHELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 PARKER ST STE 306
MAYNARD MA
01754-2180
US

IV. Provider business mailing address

3354 LOAM ST
NORFOLK VA
23518-5622
US

V. Phone/Fax

Practice location:
  • Phone: 866-991-2103
  • Fax:
Mailing address:
  • Phone: 757-237-5335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701008930
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: