Provider Demographics
NPI:1225196231
Name:MITCHELL, MARGARETTA ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARETTA
Middle Name:ANNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:M
Other - Middle Name:ANNE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSCSW
Mailing Address - Street 1:1650 6TH ST # 165
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-1804
Mailing Address - Country:US
Mailing Address - Phone:620-635-5213
Mailing Address - Fax:
Practice Address - Street 1:1650 6TH ST # 165
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-1804
Practice Address - Country:US
Practice Address - Phone:620-635-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291051041C0700X
KS23941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical