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General NPI Number Information
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NPI Number | 1477405561
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Entity Type | Individual
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Provider Name | JARED MITCHELL
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Gender |
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 700 24TH ST
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City | FORT GREGG ADAMS
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State | VA
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Zip | 23801-1716
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Country | US
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Telephone | 804-734-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 2430 HOXTON RD UNIT 3128
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City | HENRICO
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State | VA
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Zip | 23228-2270
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904015178
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License Number State | VA
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