Provider Demographics
NPI:1528538311
Name:MITCHELL, CHERISH (CHERISH)
Entity Type:Individual
Prefix:
First Name:CHERISH
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CHERISH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16788 E MANSFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-2831
Mailing Address - Country:US
Mailing Address - Phone:720-837-6876
Mailing Address - Fax:
Practice Address - Street 1:12660 E BRIARWOOD AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:720-470-0578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician