Provider Demographics
NPI:1790882355
Name:MITCHELL, BETH A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-4338
Mailing Address - Country:US
Mailing Address - Phone:609-893-2513
Mailing Address - Fax:
Practice Address - Street 1:114 RIVERBANK
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-1312
Practice Address - Country:US
Practice Address - Phone:609-386-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053223001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical