MEDICARE: JOCELYN MITCHELL BCBA

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	103K00000X	Behavior Analyst	1-19-38501	FL

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	:	1801395504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN MITCHELL BCBA

Provider Business Mailing Address
First Line	:	PO BOX 490843
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34749-0843
Country	:	US
Telephone Number	:	352-874-2986
Fax Number	:

Provider Business Practice Location Address
First Line	:	7633 PARK HILL AVE
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34748-6140
Country	:	US
Telephone Number	:	352-874-2986
Fax Number	:

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

Provider Enumeration Date	:	02/08/2018
Last Update Date	:	07/28/2023

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