Healthcare Provider Details

I. General information

NPI: 1487463097
Provider Name (Legal Business Name): MELISSA V MITCHELL PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W 4TH ST
NORTH PLATTE NE
69101-3828
US

IV. Provider business mailing address

308 W 4TH ST
NORTH PLATTE NE
69101-3828
US

V. Phone/Fax

Practice location:
  • Phone: 308-270-5581
  • Fax: 308-237-5225
Mailing address:
  • Phone: 308-270-5581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14216
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: