Provider Demographics
NPI:1801395504
Name:MITCHELL, JOCELYN (BCBA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 490843
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-0843
Mailing Address - Country:US
Mailing Address - Phone:352-874-2986
Mailing Address - Fax:
Practice Address - Street 1:7633 PARK HILL AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6140
Practice Address - Country:US
Practice Address - Phone:352-874-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-19-38501103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst