Provider Demographics
NPI:1275768707
Name:MITCHELL, HELAINE N (MFT)
Entity Type:Individual
Prefix:
First Name:HELAINE
Middle Name:N
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 WHITMORE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4687
Mailing Address - Country:US
Mailing Address - Phone:510-846-2114
Mailing Address - Fax:
Practice Address - Street 1:345 ESTUDILLO AVE
Practice Address - Street 2:207
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4702
Practice Address - Country:US
Practice Address - Phone:510-846-2114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist