Individual
MS. MELANIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,BA,LPC
Contact information
Practice address
30 PECK RD, BUILDING 2 SUITE#2203, TORRINGTON, CT 06790-6123
(860) 626-7007
(860) 626-7014
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2516
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008050691
—
CT
01
—
060669107
UNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CT
01
—
12714353
CAQH
CT
01
—
4930230
CIGNA BEHAVIORAL HEALTH
CT
01
—
531888
MHN MANAGED HEALTH NETWORK
CT
01
—
D339225-PINE ST
VALUE OPTIONS
CT
01
—
PENDING
AETNA BEHAVIORAL HEALTH
CT
Enumeration date
03/21/2012
Last updated
08/29/2016
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