Provider Demographics
NPI:1598529646
Name:PLANT MITCHELL, SHENIQUA (MSW)
Entity Type:Individual
Prefix:
First Name:SHENIQUA
Middle Name:
Last Name:PLANT MITCHELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3571
Mailing Address - Country:US
Mailing Address - Phone:347-650-1656
Mailing Address - Fax:
Practice Address - Street 1:109 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-2505
Practice Address - Country:US
Practice Address - Phone:610-599-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)