Provider Demographics
NPI:1033970272
Name:MITCHELL, MERCEDES JEAN (MA, LAPC, NCC)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:JEAN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 TERRELL MILL RD SE APT 16H
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6072
Mailing Address - Country:US
Mailing Address - Phone:517-974-7276
Mailing Address - Fax:
Practice Address - Street 1:2480 WINDY HILL RD SE STE 210
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8644
Practice Address - Country:US
Practice Address - Phone:616-841-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC007744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health