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General NPI Number Information
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NPI Number | 1750622692
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Entity Type | Individual
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Provider Name | CYNTHIA MITCHELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/01/2013
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 65B MICHAEL RD
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City | NEW LONDON
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State | CT
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Zip | 06320
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Country | US
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Telephone | 860-439-0248
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Fax |
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Provider Business Mailing Address
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Address Line | 65B MICHAEL RD
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City | NEW LONDON
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State | CT
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Zip | 06320-3945
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Country | US
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Telephone | 860-912-0529
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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 | 008191
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License Number State | CT
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