Provider Demographics
NPI:1063067015
Name:MITCHELL, LINDA MAE (LCDC, LPC, LSOTP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MAE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LCDC, LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820143
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-0143
Mailing Address - Country:US
Mailing Address - Phone:817-353-0545
Mailing Address - Fax:682-626-5177
Practice Address - Street 1:6900 BOULEVARD 26
Practice Address - Street 2:
Practice Address - City:RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8867
Practice Address - Country:US
Practice Address - Phone:214-622-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78384101Y00000X, 101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor