Provider Demographics
NPI:1568272359
Name:MITCHELL, KAILA MAE (LPC)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:MAE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 GATES LN
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1600
Mailing Address - Country:US
Mailing Address - Phone:717-743-5102
Mailing Address - Fax:
Practice Address - Street 1:620 GATES LN
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1600
Practice Address - Country:US
Practice Address - Phone:717-743-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017597101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health