MEDICARE: ROSALIND 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
1	101YM0800X	Mental Health Counselor	LPC008546	GA

General Provider Information

NPI Number	:	1285385690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALIND MITCHELL

Provider Business Mailing Address
First Line	:	1100 SPRING ST NW STE 380
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2854
Country	:	US
Telephone Number	:	404-379-3747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 SPRING ST NW STE 380
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2854
Country	:	US
Telephone Number	:	404-379-3747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	01/17/2022

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