Provider Demographics
NPI:1508067422
Name:MITCHELL, JANET ELLEN (LCSW, RPT-S)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELLEN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LCSW, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 MIDDLETOWN PARK PL STE A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2517
Mailing Address - Country:US
Mailing Address - Phone:502-245-7415
Mailing Address - Fax:
Practice Address - Street 1:306 MIDDLETOWN PARK PL STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2517
Practice Address - Country:US
Practice Address - Phone:502-245-7415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical