Organization
MITCHELL'S PLACE, INC.
Active
Other names
Mitchell's Place - South Side
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL W FITZGERALD CPAR (BILLING DIRECTOR)
(205) 957-0294
Entity
Organization
Contact information
Practice address
4778 OVERTON ROAD, BIRMINGHAM, AL 35210
(205) 957-0294
(205) 957-0298
Mailing address
4778 OVERTON ROAD, BIRMINGHAM, AL 35210
(205) 957-0294
(205) 957-0298
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
225X00000X
Occupational Therapist
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247019
—
AL
Enumeration date
03/16/2007
Last updated
06/19/2025
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