Provider Demographics
NPI:1831873280
Name:MITCHELL, NOEL MURAE (LPC-IT, MS)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:MURAE
Last Name:MITCHELL
Suffix:
Gender:
Credentials:LPC-IT, MS
Other - Prefix:
Other - First Name:NOEL
Other - Middle Name:
Other - Last Name:KWIAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1302 N 70TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-2816
Mailing Address - Country:US
Mailing Address - Phone:262-501-4346
Mailing Address - Fax:
Practice Address - Street 1:124 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-1901
Practice Address - Country:US
Practice Address - Phone:262-501-4346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7421226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health