| Carissa Mitchell Lpcc Llc | |
|
620 Kling Dr Dayton OH 45419-4201 | |
| (937) 701-7913 | |
| Not Available |
| Full Name | Carissa Mitchell Lpcc Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 620 Kling Dr, Dayton, Ohio |
| Authorized Official Name and Position | Carissa Mitchell (THERAPIST) |
| Authorized Official Contact | 9373477409 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carissa Mitchell Lpcc Llc 2233 Fauver Ave Dayton OH 45420-2522 Ph: () - | Carissa Mitchell Lpcc Llc 620 Kling Dr Dayton OH 45419-4201 Ph: (937) 701-7913 |
| NPI Number | 1518719004 |
|---|---|
| Provider Enumeration Date | 04/05/2024 |
| Last Update Date | 04/05/2024 |
| Certification Date | 04/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518719004 | NPI | - | NPPES |
| 1093289530 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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