Provider Demographics
NPI:1285267633
Name:MITCHELL, ELIZABETH LEWIS (LPC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LEWIS
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3004 13TH AVE S APT 1
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2081
Mailing Address - Country:US
Mailing Address - Phone:205-568-4649
Mailing Address - Fax:
Practice Address - Street 1:2320 HIGHLAND AVE S STE 290D
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2962
Practice Address - Country:US
Practice Address - Phone:205-568-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3911101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor