Individual
RICHARD S. MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
15 SHIRLEY AVENUE, DENNIS PORT, MA 02639-5590
(508) 394-8677
(508) 394-1180
Mailing address
15 SHIRLEY AVE, DENNIS PORT, MA 02639-2443
(508) 394-8677
(508) 394-1180
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
00396
MA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
00396
MA
103TA0700X
Adult Development & Aging Psychologist
00396
MA
103TB0200X
Cognitive & Behavioral Psychologist
Primary
00396
MA
103TC0700X
Clinical Psychologist
00396
MA
103TC1900X
Counseling Psychologist
396
MA
103TC2200X
Clinical Child & Adolescent Psychologist
00396
MA
103TF0000X
Family Psychologist
396
MA
103TH0100X
Health Service Psychologist
396
MA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
396
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0504793
—
MA
Enumeration date
07/12/2005
Last updated
04/08/2024
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