Provider Demographics
NPI:1568754018
Name:MITCHELL PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:MITCHELL PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROMANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-387-2455
Mailing Address - Street 1:5932 PULASKI AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3823
Mailing Address - Country:US
Mailing Address - Phone:215-849-7945
Mailing Address - Fax:
Practice Address - Street 1:5932 PULASKI AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3823
Practice Address - Country:US
Practice Address - Phone:215-849-7945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005301L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty