Individual
KELLY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1022 N 4TH ST STE 101, COEUR D ALENE, ID 83814-3100
(208) 457-2909
Mailing address
1022 N 4TH ST STE 101, COEUR D ALENE, ID 83814-3100
(208) 457-2909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4471283
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
475722449
PASSPORT
CA
Enumeration date
10/02/2014
Last updated
11/12/2025
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