MEDICARE: LINDSAY MITCHEL 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	101YP2500X	Professional Counselor	03803	KS
2	101YP2500X	Professional Counselor	03928	KS

General Provider Information

NPI Number	:	1700460359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY MITCHEL LPC

Provider Business Mailing Address
First Line	:	7807 E FUNSTON ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67207-3123
Country	:	US
Telephone Number	:	316-636-1188
Fax Number	:	316-636-1190

Provider Business Practice Location Address
First Line	:	6606 W CENTRAL AVE
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67212-3315
Country	:	US
Telephone Number	:	316-221-2661
Fax Number	:	316-636-1188

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

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	01/31/2023

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