Healthcare Provider Details

I. General information

NPI: 1891289815
Provider Name (Legal Business Name): ANDREA J. MITCHEL LSW,LCDC-III
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 E MAIN ST
CHILLICOTHEE OH
45601-3414
US

IV. Provider business mailing address

242 E MAIN ST
CHILLICOTHEE OH
45601-3414
US

V. Phone/Fax

Practice location:
  • Phone: 740-773-3272
  • Fax:
Mailing address:
  • Phone: 740-773-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDC.162953
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2106996
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: