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General NPI Number Information
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NPI Number | 1528614757
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Entity Type | Individual
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Provider Name | MICHELE MITCHELL LPC, CSAC, LASAC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 495 N PINAL PKWY
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City | FLORENCE
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State | AZ
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Zip | 85132-9292
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Country | US
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Telephone | 833-431-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 1469 N 1200 W
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City | OREM
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State | UT
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Zip | 84057-2449
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Country | US
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Telephone | 801-655-5450
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Fax | 385-225-9327
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17085-132
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LAAC-15558
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8796-125
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCPC-8761173
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-08043
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License Number State | AZ
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