Provider Demographics
NPI:1912723875
Name:MITCHELL, KELSEY MARIE (MSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2581 EAGLE RDG
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-6742
Mailing Address - Country:US
Mailing Address - Phone:231-571-5236
Mailing Address - Fax:
Practice Address - Street 1:700 TERRACE POINT DR STE 375
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1149
Practice Address - Country:US
Practice Address - Phone:231-571-5236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health