Provider Demographics
NPI:1265960454
Name:MITCHELL, ABIGAIL MARY (MA)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:MARY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2350
Mailing Address - Country:US
Mailing Address - Phone:318-458-3044
Mailing Address - Fax:
Practice Address - Street 1:3109 MAYFIELD RD STE 204
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1726
Practice Address - Country:US
Practice Address - Phone:440-591-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OHM.1800091106H00000X
OHF.2100218106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor