Provider Demographics
NPI:1588469209
Name:MITCHELL, SABRINA (LMSW)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 PINEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-4726
Mailing Address - Country:US
Mailing Address - Phone:662-719-0658
Mailing Address - Fax:
Practice Address - Street 1:8131 PINEBROOK DR
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4726
Practice Address - Country:US
Practice Address - Phone:662-719-0658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12674104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker