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NPI Code Detail

MEDICARE: SHARON JOY MITCHELL M.S., L.M.F.T.

MEDICARE: SHARON JOY MITCHELL M.S., L.M.F.T.
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
1106H00000XMarriage & Family Therapist2155MN

General Provider Information

NPI Number : 1275973703
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON JOY MITCHELL M.S., L.M.F.T.
Provider Business Mailing Address
First Line : 621 W LAKE ST STE 350
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2952
Country : US
Telephone Number : 612-547-9990
Fax Number : 651-925-0427
Provider Business Practice Location Address
First Line : 3112 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2619
Country : US
Telephone Number : 612-385-9605
Fax Number : 651-925-0427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2013
Last Update Date : 01/02/2019

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