Provider Demographics
NPI:1073803094
Name:MOURAD MITCHELL, JOELLE NATALIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOELLE
Middle Name:NATALIE
Last Name:MOURAD MITCHELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VETERANS BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2612
Mailing Address - Country:US
Mailing Address - Phone:650-299-4354
Mailing Address - Fax:
Practice Address - Street 1:1400 VETERANS BLVD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2612
Practice Address - Country:US
Practice Address - Phone:650-299-4354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA269891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical