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NPI Code Detail

MEDICARE: INGRID MITCHELL LCSW

MEDICARE: INGRID MITCHELL LCSW
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
11041C0700XClinical Social Worker097945NY

General Provider Information

NPI Number : 1205367927
Entity Type Code : Individual
Provider Name (Legal Business Name) : INGRID MITCHELL LCSW
Provider Business Mailing Address
First Line : 1225 GERARD AVE # 2D5
Second Line :
City : BRONX
State : NY
Zip : 10452-8015
Country : US
Telephone Number : 718-960-2620
Fax Number :
Provider Business Practice Location Address
First Line : 1225 GERARD AVE # 2D15
Second Line :
City : BRONX
State : NY
Zip : 10452-8015
Country : US
Telephone Number : 718-860-2620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2017
Last Update Date : 12/09/2024

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Directions to “ INGRID MITCHELL LCSW” Practice Location

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