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NPI Code Detail

MEDICARE: THOMAS J MITCHELL MS LPC

MEDICARE: THOMAS J MITCHELL MS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor551WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1312395OTHERWYBS OF WY

General Provider Information

NPI Number : 1063496057
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS J MITCHELL MS LPC
Provider Business Mailing Address
First Line : 501 ALBANY AVE
Second Line :
City : TORRINGTON
State : WY
Zip : 82240-1503
Country : US
Telephone Number : 307-532-4091
Fax Number : 307-532-8409
Provider Business Practice Location Address
First Line : 501 ALBANY AVE
Second Line :
City : TORRINGTON
State : WY
Zip : 82240-1503
Country : US
Telephone Number : 307-532-4091
Fax Number : 307-532-8409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 04/15/2011

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Directions to “ THOMAS J MITCHELL MS LPC” Practice Location

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