Provider Demographics
NPI:1881286417
Name:MITCHELL, POYTHRESS D (LPC)
Entity type:Individual
Prefix:MRS
First Name:POYTHRESS
Middle Name:D
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:POYTHRESS
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CSAC
Mailing Address - Street 1:3347 OYSTER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-0906
Mailing Address - Country:US
Mailing Address - Phone:757-642-7122
Mailing Address - Fax:
Practice Address - Street 1:3347 OYSTER CREEK DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-0906
Practice Address - Country:US
Practice Address - Phone:757-642-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional