Provider Demographics
NPI:1134356108
Name:MITCHELL, AARON WADE (LMHC, LMP)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:WADE
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:LMHC, LMP
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 1330
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-1330
Mailing Address - Country:US
Mailing Address - Phone:425-220-6079
Mailing Address - Fax:425-645-7102
Practice Address - Street 1:3 UALAPUE PL. 1-A
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-213-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012405225700000X
HI611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist