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NPI Code Detail

MEDICARE: MRS. JOSEPHINE V. MITCHELL

MEDICARE: MRS. JOSEPHINE V. MITCHELL
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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13747A0650XOTHERRESIDENTIAL TREATMENT

General Provider Information

NPI Number : 1093843781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOSEPHINE V. MITCHELL
Provider Business Mailing Address
First Line : 2808 SPARROW DR
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5926
Country : US
Telephone Number : 931-552-9225
Fax Number :
Provider Business Practice Location Address
First Line : 118 UNION ST
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5115
Country : US
Telephone Number : 931-647-8257
Fax Number : 931-647-2978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 10/16/2012

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Directions to “ MRS. JOSEPHINE V. MITCHELL ” Practice Location

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