Provider Demographics
NPI:1891103289
Name:URE, MITCHELL DAVID (LMSW)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:DAVID
Last Name:URE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 W OUTER RD
Mailing Address - Street 2:STE 203
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-5232
Mailing Address - Country:US
Mailing Address - Phone:314-371-6500
Mailing Address - Fax:314-371-6508
Practice Address - Street 1:3675 W OUTER RD
Practice Address - Street 2:STE 203
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-5232
Practice Address - Country:US
Practice Address - Phone:314-371-6500
Practice Address - Fax:314-371-6508
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140036441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical