MEDICARE: JARED 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	1041C0700X	Clinical Social Worker	0904015178	VA

General Provider Information

NPI Number	:	1477405561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED MITCHELL

Provider Business Mailing Address
First Line	:	2430 HOXTON RD UNIT 3128
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2270
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 24TH ST
Second Line	:
City	:	FORT GREGG ADAMS
State	:	VA
Zip	:	23801-1716
Country	:	US
Telephone Number	:	804-734-9000
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ JARED MITCHELL ” Practice Location

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