Healthcare Provider Details

I. General information

NPI: 1952234965
Provider Name (Legal Business Name): CHLOE ANN MARIE MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

505 PACKARD ST
ANN ARBOR MI
48104-3050
US

IV. Provider business mailing address

2260 DERBY RD
BIRMINGHAM MI
48009-7533
US

V. Phone/Fax

Practice location:
  • Phone: 248-933-8979
  • Fax:
Mailing address:
  • Phone: 248-933-8979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122135
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: