Provider Demographics
NPI:1346875903
Name:MITCHELL, ALICIA L
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27986-0021
Mailing Address - Country:US
Mailing Address - Phone:252-209-4062
Mailing Address - Fax:
Practice Address - Street 1:301 MAIN ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3319
Practice Address - Country:US
Practice Address - Phone:252-209-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor