Provider Demographics
NPI:1760851513
Name:MITCHELL, SARAH (MA , LLMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA , LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13346 LEDWON
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315
Mailing Address - Country:US
Mailing Address - Phone:586-604-6496
Mailing Address - Fax:
Practice Address - Street 1:13346 LEDWON ST
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-5336
Practice Address - Country:US
Practice Address - Phone:586-604-6496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010987331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical