Provider Demographics
NPI:1558873554
Name:MITCHELL, FELICIA L (MFTI)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 N WILLOW WOODS DR UNIT D
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-1458
Mailing Address - Country:US
Mailing Address - Phone:714-803-1736
Mailing Address - Fax:323-261-0809
Practice Address - Street 1:24328 VERMONT AVE STE 210
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2300
Practice Address - Country:US
Practice Address - Phone:818-643-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71657101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health