Provider Demographics
NPI:1376806422
Name:MITCHELL, SATINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SATINA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4229
Mailing Address - Country:US
Mailing Address - Phone:860-317-0262
Mailing Address - Fax:860-318-7442
Practice Address - Street 1:12 CURTIS ST STE 24
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-5900
Practice Address - Country:US
Practice Address - Phone:860-317-0262
Practice Address - Fax:860-318-7422
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT67831041C0700X
CT0067831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008043420Medicaid