Provider Demographics
NPI:1932339249
Name:JEFF MITCHELL ASSOCIATES INC
Entity Type:Organization
Organization Name:JEFF MITCHELL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-622-7361
Mailing Address - Street 1:130 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1620
Mailing Address - Country:US
Mailing Address - Phone:215-622-7361
Mailing Address - Fax:
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1620
Practice Address - Country:US
Practice Address - Phone:215-622-7361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-008626-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000416198OtherHIGHMARK
PA229 620 000OtherMAGELLEN
PA7855355OtherAETNA
PA0080851000OtherPERSONAL CHOICE
PA416 198OtherPERSONAL CHOICE
PA0080851000OtherAMERIHEALTH
PA229 620 000OtherMAGELLEN