MEDICARE: JOHANNA MITCHELL MS, NCC, LPCC/LPC-SA

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	101YP2500X	Professional Counselor	CTB-2024-0690	NM
2	101YP2500X	Professional Counselor	5064	LA

General Provider Information

NPI Number	:	1427378934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNA MITCHELL MS, NCC, LPCC/LPC-SA

Provider Business Mailing Address
First Line	:	4611 JAMAICA DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2839
Country	:	US
Telephone Number	:	504-822-6888
Fax Number	:	504-822-6886

Provider Business Practice Location Address
First Line	:	4611 JAMAICA DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2839
Country	:	US
Telephone Number	:	505-310-1036
Fax Number	:

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

Provider Enumeration Date	:	06/07/2010
Last Update Date	:	06/15/2026

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