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NPI Code Detail

MEDICARE: MRS. KELLY L MITCHELL LMHC

MEDICARE: MRS. KELLY L MITCHELL LMHC
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
1101YM0800XMental Health CounselorMH5760FL

General Provider Information

NPI Number : 1942489604
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLY L MITCHELL LMHC
Provider Business Mailing Address
First Line : 9141 CYPRESS GREEN DR
Second Line : SUITE 1
City : JACKSONVILLE
State : FL
Zip : 32256-2013
Country : US
Telephone Number : 904-733-7333
Fax Number : 904-733-5647
Provider Business Practice Location Address
First Line : 9141 CYPRESS GREEN DR
Second Line : SUITE 1
City : JACKSONVILLE
State : FL
Zip : 32256-2013
Country : US
Telephone Number : 904-733-7333
Fax Number : 904-733-5647
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2007
Last Update Date : 10/30/2007

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Directions to “ MRS. KELLY L MITCHELL LMHC” Practice Location

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