Provider Demographics
NPI:1134275217
Name:MITCHELL, JANICE LEDOUX (LICSW)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LEDOUX
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16 LEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9404
Mailing Address - Country:US
Mailing Address - Phone:413-323-7797
Mailing Address - Fax:
Practice Address - Street 1:16 LEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9404
Practice Address - Country:US
Practice Address - Phone:413-323-7797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical