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General NPI Number Information
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NPI Number | 1356890586
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Entity Type | Individual
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Provider Name | DR. JOEY MITCHELL
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Gender | Male
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 11/16/2018
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Provider Practice Location Address
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Address Line | 805 N BEECH ST STE 2
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City | TALLULAH
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State | LA
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Zip | 71282
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Country | US
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Telephone | 318-216-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N BEECH ST STE 2
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City | TALLULAH
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State | LA
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Zip | 71282-3809
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Country | US
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Telephone |
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC009909
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License Number State | GA
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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 | 6862
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License Number State | LA
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