Provider Demographics
NPI:1932115888
Name:MITCHELL, SARAH G (LISW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:G
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 SIERRA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-6804
Mailing Address - Country:US
Mailing Address - Phone:505-268-0690
Mailing Address - Fax:505-265-3844
Practice Address - Street 1:6000 SUMMER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6738
Practice Address - Country:US
Practice Address - Phone:505-268-0690
Practice Address - Fax:505-265-3844
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-049711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical