Provider Demographics
NPI:1326233883
Name:MITCHELL, BADONNA (LMFT)
Entity Type:Individual
Prefix:
First Name:BADONNA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 OLD SAINT AUGUSTINE RD STE 10
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4881
Mailing Address - Country:US
Mailing Address - Phone:850-942-8810
Mailing Address - Fax:
Practice Address - Street 1:2002 OLD SAINT AUGUSTINE RD STE 10
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4881
Practice Address - Country:US
Practice Address - Phone:850-942-8810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GAMFT001284106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health