Healthcare Provider Details

I. General information

NPI: 1568374502
Provider Name (Legal Business Name): ABIGAYLE MAE MITCHELSON M.A LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 E GILES RD
MUSKEGON MI
49445-2622
US

IV. Provider business mailing address

1555 LOUMILEN DR
MUSKEGON MI
49445-1585
US

V. Phone/Fax

Practice location:
  • Phone: 231-744-4777
  • Fax:
Mailing address:
  • Phone: 231-744-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number6154024108
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: