Provider Demographics
NPI:1518127802
Name:MITCHELL, ALAN LEONARD (CAC-AD)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEONARD
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BAY ST STE 307
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-2796
Mailing Address - Country:US
Mailing Address - Phone:410-819-5911
Mailing Address - Fax:410-819-0591
Practice Address - Street 1:301 BAY ST STE 307
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2796
Practice Address - Country:US
Practice Address - Phone:410-819-5911
Practice Address - Fax:410-819-0591
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0355101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)