Provider Demographics
NPI:1750532453
Name:MITCHELL, WILLIAM STUART (LCSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STUART
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGHLANDS DR
Mailing Address - Street 2:SUITE 301B
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7693
Mailing Address - Country:US
Mailing Address - Phone:717-627-0858
Mailing Address - Fax:717-627-1744
Practice Address - Street 1:100 HIGHLANDS DR
Practice Address - Street 2:SUITE 301B
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7693
Practice Address - Country:US
Practice Address - Phone:717-627-0858
Practice Address - Fax:717-627-1744
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical