Organization
CARISSA MITCHELL LPCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARISSA MITCHELL (THERAPIST)
(937) 347-7409
Entity
Organization
Contact information
Practice address
620 KLING DR, DAYTON, OH 45419-4201
(937) 701-7913
Mailing address
2233 FAUVER AVE, DAYTON, OH 45420-2522
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093289530
—
OH
Enumeration date
04/05/2024
Last updated
04/05/2024
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