Provider Demographics
NPI:1144398587
Name:MITCHELL, PATRICIA JANE (MSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JANE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 GLENFORD WITTENBERG RD
Mailing Address - Street 2:
Mailing Address - City:GLENFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12433-5124
Mailing Address - Country:US
Mailing Address - Phone:845-657-2969
Mailing Address - Fax:845-657-6048
Practice Address - Street 1:108 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1106
Practice Address - Country:US
Practice Address - Phone:845-876-7082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO18335-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical