Provider Demographics
NPI:1417598715
Name:MITCHELL, CHRISTOPHER D
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:MITCHELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BELLE VISTA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH TROY
Mailing Address - State:VT
Mailing Address - Zip Code:05859-9613
Mailing Address - Country:US
Mailing Address - Phone:802-323-6363
Mailing Address - Fax:
Practice Address - Street 1:204 BELLE VISTA RD
Practice Address - Street 2:
Practice Address - City:NORTH TROY
Practice Address - State:VT
Practice Address - Zip Code:05859-9613
Practice Address - Country:US
Practice Address - Phone:802-323-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
VT068.0134321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health