MEDICARE: LOIS A.BRANDCHAFT MITCHELL LPC

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	0701003969	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538277694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOIS A.BRANDCHAFT MITCHELL LPC

Provider Business Mailing Address
First Line	:	5133 PORTSMOUTH RD
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-2230
Country	:	US
Telephone Number	:	703-278-8396
Fax Number	:

Provider Business Practice Location Address
First Line	:	12721 DARBY BROOK CT
Second Line	:	STE.102
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-2408
Country	:	US
Telephone Number	:	703-497-1771
Fax Number	:	703-497-1225

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/08/2007

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