Provider Demographics
NPI:1952767360
Name:MITCHELL, MONIQUE
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12910 ASHLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2502
Mailing Address - Country:US
Mailing Address - Phone:504-241-6006
Mailing Address - Fax:504-241-6007
Practice Address - Street 1:12910 ASHLAND DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128
Practice Address - Country:US
Practice Address - Phone:504-241-6006
Practice Address - Fax:504-241-6007
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker