Provider Demographics
NPI:1720825201
Name:RICHARD MITCHELL
Entity type:Organization
Organization Name:RICHARD MITCHELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MS
Authorized Official - Phone:406-616-6503
Mailing Address - Street 1:15 RAPTOR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLANCY
Mailing Address - State:MT
Mailing Address - Zip Code:59634-8545
Mailing Address - Country:US
Mailing Address - Phone:406-616-6503
Mailing Address - Fax:800-480-7615
Practice Address - Street 1:15 RAPTOR RIDGE DR
Practice Address - Street 2:
Practice Address - City:CLANCY
Practice Address - State:MT
Practice Address - Zip Code:59634-8545
Practice Address - Country:US
Practice Address - Phone:406-616-6503
Practice Address - Fax:800-480-7615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty