Provider Demographics
NPI:1194553917
Name:MITCHELL, AL-JUMAL (LPC)
Entity type:Individual
Prefix:
First Name:AL-JUMAL
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 GRAVELO CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-3628
Mailing Address - Country:US
Mailing Address - Phone:443-791-2600
Mailing Address - Fax:
Practice Address - Street 1:47 GRAVELO CIR
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-3628
Practice Address - Country:US
Practice Address - Phone:443-791-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-08-26
Deactivation Date:2024-07-29
Deactivation Code:
Reactivation Date:2024-08-26
Provider Licenses
StateLicense IDTaxonomies
PA08872101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health