Provider Demographics
NPI:1770571697
Name:MITCHEFF, RITA M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:M
Last Name:MITCHEFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:611 LINCOLNWAY E
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-3220
Mailing Address - Country:US
Mailing Address - Phone:574-232-2255
Mailing Address - Fax:574-232-8968
Practice Address - Street 1:1411 LINCOLNWAY W
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-1626
Practice Address - Country:US
Practice Address - Phone:574-256-2255
Practice Address - Fax:574-257-1295
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005021A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2328864OtherCIGNA
IN000000365161OtherUNICARE
IN000000365161OtherANTHEM
IN148470QMedicare PIN