Provider Demographics
NPI:1033486816
Name:MITCHELL, FADRA ANDREWS (LMSW, LAC)
Entity Type:Individual
Prefix:MS
First Name:FADRA
Middle Name:ANDREWS
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LMSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1365
Mailing Address - Country:US
Mailing Address - Phone:913-952-6696
Mailing Address - Fax:913-602-8474
Practice Address - Street 1:9250 GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1365
Practice Address - Country:US
Practice Address - Phone:913-952-6696
Practice Address - Fax:913-602-8474
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS658101YA0400X
KS7638104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)