Provider Demographics
NPI:1558694075
Name:MITCHELL, JAMES DENNIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DENNIS
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 NE 5TH TER
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2325
Mailing Address - Country:US
Mailing Address - Phone:954-213-9480
Mailing Address - Fax:
Practice Address - Street 1:4710 NE 5TH TER
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-2325
Practice Address - Country:US
Practice Address - Phone:954-213-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW129901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical