MEDICARE: ASHLEE 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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1396503959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEE MITCHELL

Provider Business Mailing Address
First Line	:	34466 CEDAR TRL
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-2992
Country	:	US
Telephone Number	:	440-832-1983
Fax Number	:

Provider Business Practice Location Address
First Line	:	17325 EUCLID AVE STE 4104
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-1262
Country	:	US
Telephone Number	:	216-284-6031
Fax Number	:

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

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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Directions to “ ASHLEE MITCHELL ” Practice Location

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