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General NPI Number Information
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NPI Number | 1336721000
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Entity Type | Individual
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Provider Name | JEFFREY THOMAS MITCHELL MA, MS, LPS, LAC
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Gender | Male
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 757 MALETA LN STE 101
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City | CASTLE ROCK
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State | CO
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Zip | 80108-7612
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Country | US
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Telephone | 720-733-8886
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Fax | 720-733-8894
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Provider Business Mailing Address
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Address Line | 757 MALETA LN STE 101
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City | CASTLE ROCK
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State | CO
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Zip | 80108-7612
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Country | US
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Telephone | 303-396-7049
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Fax | 720-733-8894
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ACC.0006290
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | ACC.0006290
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACC.0006290
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | ACC.0006290
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License Number State | CO
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