Provider Demographics
NPI:1427378934
Name:MITCHELL, JOHANNA (MS, NCC, LPCC/LPC-SA)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, NCC, LPCC/LPC-SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 JAMAICA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2839
Mailing Address - Country:US
Mailing Address - Phone:504-822-6888
Mailing Address - Fax:504-822-6886
Practice Address - Street 1:4611 JAMAICA DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2839
Practice Address - Country:US
Practice Address - Phone:505-310-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0690101YM0800X
LA5064101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty