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General NPI Number Information
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NPI Number | 1427378934
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Entity Type | Individual
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Provider Name | JOHANNA MITCHELL MS, NCC, LPCC/LPC-SA
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Gender | Female
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 4611 JAMAICA DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2839
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Country | US
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Telephone | 505-310-1036
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Fax |
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Provider Business Mailing Address
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Address Line | 4611 JAMAICA DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2839
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Country | US
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Telephone | 504-822-6888
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Fax | 504-822-6886
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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 | CTB-2024-0690
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License Number State | NM
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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 | 5064
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License Number State | LA
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