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General NPI Number Information
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NPI Number | 1235263419
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Entity Type | Organization
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Legal Business Name | MITCHELL'S PLACE, INC.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 4778 OVERTON ROAD
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City | BIRMINGHAM
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State | AL
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Zip | 35210
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Country | US
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Telephone | 205-957-0294
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Fax | 205-957-0298
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Provider Business Mailing Address
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Address Line | 4778 OVERTON ROAD
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City | BIRMINGHAM
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State | AL
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Zip | 35210
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Country | US
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Telephone | 205-957-0294
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Fax | 205-957-0298
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | DARRELL W FITZGERALD
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Credential | CPAR
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Telephone | 205-957-0294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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Taxonomy #4
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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Taxonomy #6
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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